ABSTRACT
Objective To investigate the clinical value of endoscopy in the treatment of choledocholithiasis. Methods All 227 patients underwent endoscopic treatment. 14 of them with stones less than 1. 0 cm in diameter were treated with endoscopic papillary balloon dilation; 194 patients with stones 1. 0-1. 5 cm in diameter were treated with endoscopic sphincterotomy; and 19 patients with stones up to 1.5 cm in diameter were treated with endoscopic mechanical lithotripsy. Results Choledocholithiasis were not confirmed by choledochography in 34 cases ( 15% , 34/227) , who underwent exploration of common bile duct through EPBD or EST, but no stones were found. In 187 of the 193 choledocholithiasis patients their stones were removed, the overall success rate with complete stones clearance was 96.9% ( 187/193). The incidence of complication was totally 5. 29% ( 12/227) , including acute cholangitis in 3 patients, acute pancreatitis in 8 patients, and bleeding in 1 patient. Conclusions Endoscopic treatment should be the first choice of patient with choledocholithiasis due to its advantages of safety, effectiveness and with less complication. EPBD or EST was not recommended in case of the common bile duct stones were not confirmed by ERCP, in order to avoid the risk of papilla injury.