Long-term efficacy analysis of limited endoscopic sphincterotomy with large balloon dilation and endoscopic duodenal papillary sphincterotomye for treatment of common bile duct stones
Objective This paper aims to compare the long-term efficacy of limited endoscopic sphincterotomy with large balloon dilation(ESLBD)and endoscopic duodenal papillary sphincterotomye(EST)for the treatment of common bile duct stones.Methods A hundred and thirty-one patients with common bile duct stones treated with EST or ESLBD(12-15 mm)at the Digestive Endoscopy Center of Ruijin Hospital,School of Medicine,Shanghai Jiao Tong University,and Shuguang Hospital,Shanghai University of Traditional Chinese Medicine from January 2009 to January 2020 were selected and assigned to the EST group(n=70)and the ESLBD group(n=61).The success rate of complete stone removal,and the incidence of recent and long-term complications after endoscopic retrograde cholangiopancreatography(ERCP)were compared between the two groups.Results There is no statistically significant difference in the success rate of stone extraction and mechanical fragmentation between the EST group and the ESLBD group(98.6%versus 100.0%,24.3%versus 18.0%,and P＞0.05).The incidence of recent complications after ERCP in the EST group is higher than that in the ESLBD group(8.6%versus 3.3%),but the difference is not statistically significant(P＞0.05).The long-term follow-up results show that there is no statistically significant difference in the incidence of long-term complications after ERCP between the EST group and the ESLBD group(11.9%versus 8.6%,and P＞0.05).Conclusions Compared with EST,ESLBD(12-15 mm)is a safe and effective treatment for common bile duct stones.Especially for special patients with concomitant duodenal papillary diverticulum and coagulation dysfunction,ESLBD can be the preferred treatment method.The incidence of long-term postoperative complications in EST and ESLBD is similar,and ESLBD can also cause varying degrees of damage to the function of the duodenal papillary sphincter.
Endoscopic duodenal papillary sphincterotomyeLimited endoscopic sphincterotomy with large balloon dilationCommon bile duct stones
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