ABSTRACT
Objective To compare the clinical efficacy and safety of endoscopic papillary balloon dilation (EPBD) and endoscopic papillary balloon dilation (EPBD) combined with small endoscopic sphincterotomy (SEST) in treatment of large choledocholithiasis. Methods 78 patients with large choledocholithiasis from January 2014 to December 2015 were randomly divided into EPBD group, and combination treatment group. The level of bilirubin, transaminase, alkaline phosphatase (ALP) before and after the operation, the success rates of stone removal, serum amylase of 24 h after the operation, the operation times of endoscopic retrograde cholangiopancreatography (ERCP) and whether complicated with postoperative pancreatitis were compared between the two groups. Results There was no significant difference of the success rates of stone removal, serum amylase of 24 h after the operation, the operation times of ERCP between the two groups. The level of bilirubin, transaminase, alkaline phosphatase (ALP) was declined after EPBD or EPBD and SEST, and the results of the two groups had no statistical significance (P > 0.05). Also there was no significant difference of the incidence of postoperative pancreatitis, postoperative bleeding and postoperative hyperamylasemia between the two groups (P > 0.05). Conclusion EPBD is worthy of promoting because it has a similar clinical efficacy and safety to EPBD and SEST in treatment of large choledocholithiasis.
ABSTRACT
Objective To compare the clinical efficacy of covered and uncovered metal stents in treatment of malignant biliary obstruction. Methods 123 cases of malignant biliary obstruction from May 2003 to May 2014. The survival time, the stent patency rates, the effective and biochemical indexes between the two groups were analyze and compared, follow-up period ended in March 2015. Results The level of bilirubin, transaminase, alkaline phosphatase (ALP) was declined after the covered and uncovered metal stents placed by ERCP, and the results of the two groups had no statistical significance (P > 0.05). Also there was no significant difference of the incidence of postoperative cholangitis and the cumulative survival rate between the two groups (P > 0.05). One year survival rates was related to tumor types (r = -1.55, P < 0.05). Conclusions Covered and uncovered metal stents for malignant biliary obstruction have no statistically significant about remission of liver function, stent occusion and the cumulative survival rate.