Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct stones - 22/08/11
Reprint requests: Dae Hwan Kang, MD, Department of Internal Medicine, Pusan National University College of Medicine, 1-10 Ami-dong, Seo-Gu, Busan 602-739, Korea.Busan, Korea
Abstract |
Background |
Endoscopic sphincterotomy (EST) to remove bile-duct stones is the most frequently used endoscopic technique. Few reports exist regarding application of large-balloon dilation (LBD) after EST for treatment of patients with bile-duct stones.
Objective |
To compare the effect of EST plus LBD with that of EST alone.
Design |
A prospective randomized controlled trial.
Setting |
A large tertiary-referral center.
Patients and Interventions |
Two hundred consecutive patients with bile-duct stones were randomized in equal numbers to EST plus LBD (12- to 20-mm balloon diameter) or EST alone.
Main Outcome Measurements |
Successful stone removal and complications such as pancreatitis and bleeding.
Results |
EST plus LBD compared with EST alone resulted in similar outcomes in terms of overall successful stone removal (97.0% vs 98.0%), large size (>15 mm) stone removal (94.4% vs 96.7%), and the use of mechanical lithotripsy (8.0% vs 9.0%). Complications were similar between the 2 groups (5.0% vs 7.0%, P = .767). Complications were as follows for the EST plus LBD group and the EST group: pancreatitis, 4.0% and 4.0%; cholecystitis, 1.0% and 1.0%; and bleeding (delayed), 0% and 2.0%, respectively.
Conclusions |
Based on the similar rates of successful stone removal and complications, EST plus LBD should be an effective alternative to EST. EST plus LBD is a safe and effective treatment for endoscopic removal of common bile duct stones.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : CBD, EPBD, EST, INR, LBD, SD
Mappa
| See CME section; p. 768. |
Vol 66 - N° 4
P. 720-726 - ottobre 2007 Ritorno al numero
Articolo precedente
- Ampullary and biliary stenosis: a delayed sphincterotomy complication—easy to forget, tough to treat
- Gregory B. Haber
- Is combination biliary sphincterotomy and balloon dilation a better option than either alone in endoscopic removal of large bile-duct stones?
- Jeffrey H. Lee
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