Prospective Analysis of Endoscopic Papillary Balloon Dilatation and Endoscopic Sphincteroto my for Removal of Common Bile Duct Stones

Cho, Young Deok; Moon, Jong Ho; Lee, Moon Sung; Shim, Chan Sup

Abstract

BACKGROUND/AIMS: Endoscopic papillary balloon dilatation (EPBD) is a less invasive alternative method to endoscopic sphincterotomy (EST) in the removal of common bile duct (CBD) stones. The aim of this study was to compare the success and complication rates between EST and EPBD in th removal of CBD stones.
METHODS
Eighty four patients who were diagnosed to have CBD stones on endoscopic retrograde cholangiopancreatography were included in the study. The patients were ran domly assigned to EST group (number of cases=42, mean age: 57.1 years) or EPBD group (numbe of cases=42, mean age: 58.9 years).
RESULTS
Complete stone removal by an endoscopic session was achieved in 90.5% of the EST group and 80.9% of the EPBD group. The overall success rate of com plete stone removal was 97.6% in the EST group and 90.5% in the EPBD group. The number o mean session of endoscopic procedure for complete removal of stones was 1.3 in the EST group and 1.5 in the EPBD group. Mechanical lithotripsy or ESWL was performed in 26.2% of EST group and in 45.2% of EPBD group (p<0.05). The rate of early complications after EST or EPBD was 16.7% and 14.3%, respectively.
CONCLUSIONS
EPBD is a safe and effective alternative method to EST in the management of CBD stones. However, mechanical lithotripsy or ESWL is more frequently required in EPBD than in EST to facilitate the complete ductal clearance in case with larger stones.