Meta Analysis Of The Comparison Of The Efficacy Of Endoscopic Balloon Dilatation Alone Versus Combined Endoscopic Sphincterotomy For Common Bile Duct Stones

Objective:To systematically evaluate the efficacy of endoscopic balloon dilatation(EPBD)alone and combined with endoscopic sphincterotomy(EST)in the treatment of bile duct stones.Methods:Pub Med,Cochrane,EMBASE,CNKI,Wanfang and VIP databases were searched by computer.All eligible randomized controlled trials were included and data were analyzed by Revman 5.3 software.Results:A total of 9 studies involving 848 patients were included,including 432 cases in EPBD group and 416 cases in EST + EPBD group.Meta analysis showed that:(1)The one-time success rate of EST + EPBD was higher than that of EPBD alone [MD = 2.27,95% CI(1.15,4.49),P = 0.02],and subgroup analysis showed that there was a significant difference in the success rate of one-time lithotomy by year and the largest diameter of balloon(P = 0.02);(2)The stone removal time of EST + EPBD group was shorter than that of EPBD alone [MD =-1.04,95% CI(-2.00,-0.09),P = 0.03];(3)There was no significant difference in the total success rate between the two groups [or = 1.42,95% CI(0.80,2.51),P = 0.23];(4)There was no significant difference in the rate of mechanical lithotripsy between the two groups[MD = 0.76,95% CI(0.47,1.21),P = 0.25];(5)There was no significant difference in complications between the two groups[MD = 0.90,95% CI(0.60,1.35),P = 0.60].Conclusion:EST + EPBD can shorten the time of stone removal and improve the success rate of one-time lithotripsy in the treatment of choledocholithiasis.The total success rate and mechanical lithotripsy rate of EST + EPBD are similar to those of EPBD alone.EST + EPBD is a safe and effective endoscopic treatment for common bile duct stones.