Small Endoscopic Sphincterotomy Combined With Balloon Dilation Vers Large EST For Common Bile Duct Stones: A Clinical Comparison Study

ObjectiveTo evaluate the therapeutic efficacy and safety of small endoscopic sphincterotomyplus balloon dilation vers large endoscopic sphincterotomy, for common bile duct stones.MethodsPatients with common bile duct stones on endoscopic retrograde eholangiopancreat-ography from Janauary2009to December2011were randomly divided into2groups toreceive large endoscopic sphincterotomy or small endoscopic sphincterotomy plus balloondilation,respectively.The success rate of complete stone removal, therates of early compl-complcomplications(acute pancreatitis,bleeding,perfortion,biliary infection)and long termcomplications reflux cholangitis,the recurrence of hepatolithiasis)related to the procedurewere compared between the2groups.The average hospitalization days were compared too.ResultsThe overall successful remove rate between large endoscopic sphincterotomy groupor small endoscopic sphincterotomy plus balloon dilation group was not significantlydifferent（χ2＝0.45,P＞0.05）. Significant difference were observed in terms of the earlyand long term complication rates between these two groups(χ2=4.24,P＜0.05; χ2=9.30P <0.05)。However,EST group needed more hospitalization days（9.0±3.2vs8.0±2.9,t=2.57,P <0.05).ConclusionEndoscopic sphincterotomy plus balloon dilation is superior to large endoscopicsphincterotomy alone.And it is an safe and effective, convenient for endoscopic removal ofcommon bile duct stones.