Endoscopic sphincterotomy plus balloon dilation for difficult bile duct stones

Abstract

Objectiye To evaluate the therapeutic efficacy and safety of （endoscopic sphincterotomy, EST） plus balloon dilation for difficult bile duct stones. Methods Patients with difficult common bile duct stones on endoscopic retrograde cholangiopancreatography （ERCP） from March 2008 to December 2009 were randomly divided into 2 groups to receive EST or EST plus balloon dilation （ EST ＋ EPBD）, respectively. The success rate of complete stone removal, number of endoscopic sessions, the rate of using mechanical lithotripsy and the complication rate related to the procedure were compared between the 2 groups. Results Compared with EST alone, EST plus balloon dilation resulted in similar outcomes in terms of overall successful stone removal rate （2/62 vs. 2/61 ） and early complication rate （4/62 vs. 6/61, P ＞0. 05）. However,EST group needed more sessions （ EST 15/46 vs. EST ＋ EPBD 5/57, P ＜0. 05） and use of mechanical lithotripsy to achieve complete removal of stones （ EST 12/61 vs. EST ＋ EPBD 4/61, P ＜0. 05 ）. Conclusion EST plus balloon dilation is as safe and effective as, but more convenient than EST, for endoscopic removal of common bile duct stones. Key words: Common bile duct stone; Sphincterotomy, endoscopic; Balloon dilation