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Endoscopic papillary large‐balloon dilation versus endoscopic papillary regular‐balloon dilation for removal of large bile‐duct stones
Author(s) -
Fujisawa Toshio,
Kagawa Koichi,
Hisatomi Kantaro,
Kubota Kensuke,
Nakajima Atsushi,
Matsuhashi Nobuyuki
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.42
Subject(s) - balloon dilation , medicine , bile duct , lithotripsy , balloon , common bile duct , balloon dilatation , surgery
Background Endoscopic papillary large‐balloon dilation ( EPLBD ) became popular for the treatment of large common bile‐duct stones ( CBDS ), and its feasibility has been reported in comparison to endoscopic sphincterotomy. However, the comparison between EPLBD and endoscopic papillary regular‐balloon dilation ( EPBD ) has not been reported. In the present study, the efficacy and complications of EPLBD were compared with those of EPBD . Methods We retrospectively assessed 334 consecutive patients with CBDS of any size that were treated by either EPLBD or EPBD between J anuary 2008 and D ecember 2012. Results In cases with large CBDS (>10 mm), EPLBD and EPBD had similar results in terms of the success rate of stone removal in the first (65% vs. 84%) and total attempts (100% vs. 95%), use of mechanical lithotripter (64% vs. 80%), and procedure time (48.0 ± 17.8 min vs. 44.1 ± 17.1 min). The necessity for crushing stones with a mechanical lithotripter was significantly decreased in EPLBD compared to EPBD (25% vs. 80%). In all cases with CBDS , there was no significant difference in complication rates between EPLBD and EPBD (3.3% vs. 4.7%). Conclusions Compared to EPBD , EPLBD appears safe and effective for removing large CBDS and decreases the necessity of lithotripsy.