Endoscopic papillary large balloon dilation alone or combined with small or complete sphincterotomy for the removal of large common bile duct stones  

作　　者：Qing-Hai Chen Peng Jin Hai-Wei Du Jun-Hua Lu Lei shi 

机构地区：[1]Department of Surgery,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China [2]Department of Endoscopy center,Tianjin People's Hospital Tianjin Union Medical Center,Tianjin 300121,China

出　　处：《TMR Aging》2020年第2期67-73,共7页衰老研究

摘　　要：Background:Endoscopic papillary large balloon dilation(EPLBD)has been proposed as an alternative to manage large bile duct stones.However,EPLBD alone or combined with sphincterotomy remains controversial.Methods:Between Jan.2014 and Dec.2017,195 consecutive patients with proven large common bile duct stones(size≥10 mm)were retrospectively analyzed.We compared the baseline characteristics,procedure time,success rate of stone removal and morbidity outcomes in different groups.Results:There were no significant difference between baseline characteristics of the groups compared.A total of 89.2%,95.4%,and 93.8% of the patients in the EPLBD,EPLBD+small sphincterotomy(SES),and EPLBD+complete sphincterotomy(CES)groups had stones cleared(P=0.473),respectively.There was no difference in terms of procedure time(33.5±10.2,34.8±9.0,34.9±8.2,in the EPLBD,EPLBD+SES,and EPLBD+CES groups,respectively).However,when assigned to tvvo groups according to bile duct stones diameter(bile duct stones<13 mm,bile duct stones≥13 mm).in the bile duct stones<13 mm group,the procedure time was significantly less in the EPLBD group than the EPLBD+SES group and the EPLBD+CES group(P=0.028).In the bile duct stones≥13 mm group,the mechanical lithotripsy rate of EPLBD was significantly higher compared to EPLBD+SES or EPLBD+CES(P=0.032).The complication rates were similar among all groups.Conclusions:The diameter of bile duct stones should be taken into consideration when choosing EPLBD alone or combined with small sphincterotomy for the removal of common bile duct stones.

关 键 词：Endoscopic papillary large balloon dilation Small endoscopic sphincterotomy Complete endoscopic sphincterotomy Common bile duct stones Mechanical lithotripsy Endoscopic retrograde cholangiopancreatography 

分 类 号：R57[医药卫生—消化系统]