Endoscopic Papillary Balloon Dilation For The Removal Of Common Bile Duct Stones

Objective: To evaluate the efficiency and safety of application of conscious sedation on ERCP. Methods: 199 patients needed ERCP were randomly divided into two groups, namely the contrast group (98 cases) and the disposal group (101 cases). The patients of the contrast group received diazepam 10 mg i.m., while the patients of disposal group received conscious sedation agent midazolam i.v. (total dose 0.05mg/kg) before ERCP. The physiological index and the sense degree of the patients were monitored during preoperative, in-operative and postoperative phases. Results: The patients receiving midazolam showed better tolerance, and the cardiovascular and respiratory function parameters in patients with disposal group excelled those of the controls. Conclusions: Conscious sedation is safe and effective in ERCP.conscious sedation; ERCP; midazolamBackground: Endoscopic papillary balloon dilatation (EPBD) of the sphincter of Oddi has been proposed as an alternative therapy with possible advantages, as compared with endoscopic sphincterotomy (EST), for removal of bile duct stones. Methods: 80 consecutive patients with common bileduct stones on endoscopic retrograde cholangiopancreatography (ERCP) who met all eligibility criteria were randomly assigned EST or EPBD. Complications were classified by an expert panel unaware of treatment allocation and outcome. Results: After a single ERCP, all stones were removed from 28 patients (70%) assigned EST and 26(65%) assigned EPBD. Mechanical lithotripsy was used to fragment stones in 17 (42.5%)EPBD procedures and 9 (22.5%)EST procedures (p<0.05). Early complications occurred in 5 EST patients and 4 EPBD patients. No patient died. Only one patient had bleeding after EST. One patient in each group had pancreatitis. Conclusions: The success rate of EPBD was similar to that of EST. We found there is no evidence of the previously suggested higher risk of pancreatitis with EPBD and suggest that EPBD is preferred in patients that not suitable for EST such as high risk of bleeding after EST. This procedure is a valuable alternative to EST in patients with bile duct stones.