Safety And Feasibility Assessment Of Endoscopic Papillary Large Balloon Dilation And Endoscopic Minor Sphincterotomy Plus Large Balloon Dilatation For Large Bile Duct Stones In Elderly Patients

Objective: To investigate the efficiency and safety of endoscopic papillary large balloon dilation(EPLBD)and endoscopic sphincterotomy plus large balloon dilatation(EST+EPLBD)in treatment of elderly patients with common bile duct(CBD)stones.Methods: Retrospectively analyzed the clinical data of elderly patients with 10-20 mm CBD stones who received EPLBD or EST+EPLBD from 2013.01 to 2015.12 in Anhui Provincial Hospital.Results: There was no significant difference in the final success rates(61/64,95.3%;49/ 52,94.23%)and in the success rates in the first session(57/64,89.06%;47/52,90.38%)between EPLBD and EST+EPBD.The use of mechanical lithotripsy was more frequent in the EPLBD(41.98% vs.14.29%,P < 0.05).There was no significant difference in the recurrence of asymptomatic hyperamylasemia(22/61,36.07%;14/49,28.57%),pancreatitis(5/61,8.2%,3/49,6.12%),bleeding(0/61,0%;1/49,2.04%)and choledocholithiasis(4/61,6.56%;3/49,6.12%)between EPLBD and EST+EPBD.There were no cases of perforation or death in either group.The rates of short-term complications were similar between the two groups(31/61,50.82%;21/49,42.86%).Conclusion: EST and EPLBD,the two operative methods with similar stone-free rate and the incidence rate of recent complications.EPLBD can be safely performed for large bile duct stones in elderly patients.Are EPLBD can replace EST and EPLBD requires further research and exploration.