Open AccessEndoscopic papillary balloon dilatation in comparison with endoscopic sphincterotomy for the treatment of large common bile duct stone
Author(s) -
Mahammad Minakari,
Rahil R Samani,
Ahmad Shavakhi,
Alireza Jafari,
Neda Alijanian,
Mehri Hajalikhani
Publication year - 2013
Publication title -
advanced biomedical research
Language(s) - English
Resource type - Journals
ISSN - 2277-9175
DOI - 10.4103/2277-9175.114186
Subject(s) - medicine , balloon dilatation , perforation , common bile duct stone , common bile duct , balloon , pancreatitis , balloon dilation , complication , bile duct , surgery , endoscopic treatment , endoscopy , punching , materials science , metallurgy
Background: There are concerns on the efficacy and safety of endoscopic papillary balloon dilatation (EPBD) as an alternative to endoscopic sphincterotomy (EST) in the treatment of choledocholithiasis. We compared the efficacy and safety of EPBD and EST for removing large common bile duct (CBD) stones. Materials and Methods: One hundred sixty patients with CBD stones of 10-20 mm were randomized to undergo EPBD or EST. A 15-mm dilatation balloon was used for EPBD. Cotton′s criteria were used to determine the incidence of post-EPBD or post-EST complications. CBD stone removal and complications were compared between the two methods. Results: CBD stones were completely removed in 97.5% of the EPBD and 96.2% of the EST group ( P = 0.5). The incidence of postoperative pancreatitis (11.2% vs 8.7%) and bleeding (1.2% vs 1.2%) were similar between the EPBD and EST groups ( P > 0.05). Perforation did not occur in any patient.Conclusions: EPBD with 15-mm dilator balloon appears to be equally safe and effective compared with EST for removal of large CBD stones. So because of low complication and high success rate we recommend EPBD as the preferred method for removal of large (10-20 mm) CBD stones