Efficacy and complications in endoscopic sphincterotomy and limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation for choledocholithiasis / 中华消化内镜杂志

ABSTRACT

Objective To compare efficacy and complications of endoscopic sphincterotomy(EST) and limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD) for choledocholithiasis.Methods A total of 120 choledocholithiasis patients (stone diameter ≤ 2 cm)underwent endoscopic treatment,including 60 cases of EST,60 ESBD.The stone-free rate,complication rate of postERCP pancreatitis,hemorrhage,perforation and recurrence rate of stones were compared between two groups.Results Success rates of one-time removal were 90.0％ (54 cases) and 93.3％ (56 cases) in group EST and ESBD (x2 =0.436,P =0.743).Eleven case (18.3％) and 4 case (6.7％) underwent mechanical lithotripsy(x2=3.733,P =0.053).There were 4 cases of hemorrhage,6 post-ERCP pancreatitis and 1 perforation in EST group,while in ESBD group,there was 1 case of hemorrhage,4 pancreatitis and no perforation.The total rates of early complications were 18.3％ (11/60) and 8.3％ (5/60) in two groups (x2 =3.322,P =1.422) and recurrence rate of stones were 21.7％ (13/60) and 6.7％ (4/60) respectively (x2=5.551,P =0.034).Conclusion There are no significant differences between EST group and ESBD group in treatment of choledocholithiasis,in success rate of one-time removal and the occurrence of early complications,but the recurrence rate of late complications in ESBD group is lower than that in EST group.ESBD shows high efficacy and safety for younger patient of choledocholithiasis.