Small Sphincterotomy Combined With Endoscopic Papillary Ballon Dilation Of Bile Duct Stones Retrospectively Analyzed

Objective:In the comparison with endoscopic sphincterotomy small incision endoscopic sphincterotomy combined with balloon effect treatment for common bile duct stones.Methods:By September 2008 to May 2013 at our Hospital to accept alone sphincterotomy (EST) (n= 83), a small endoscopic sphincterotomy combined with endoscopic papillary balloon dilatation (EPBD-EST) (n= 81) treatment of clinical the data of common bile duct stones were retrospectively analyzed. And two sets of material based on stone diameter(D) into 1.0cm≤D<1.3cm group and D≥ 1.3cm group, were compared between the two intact stone, take stone times, frequency of use mechanical lithotripsy and overall endoscopic short-term and long-term complications after treatment and so on differences.Results:EPBD-EST group after operation of the sphincterotomy opening diameter of 10.17 ± 1.64mm, EST group after operation of the sphincterotomy opening diameter of 6.75± 1.21mm.EPBD-EST group and EST group Overall stones removed intact were 70.4% and 38.5%(p<0.001), a success rate of stone 90.1% and 75.9%(p<0.05), mechanical lithotripsy frequency 29.6% and 61.5%(p<0.001), Stone time 39.9±5.1min and 47.8±4.2min (p<0.001). In group 1.0cm≤D<1.3cm, EPBD-EST group and EST group complete removal were 95.1% and 50% (p<0.001), group D>1.3cm 45% and 22.9%(p<0.05); In group 1.0cm<D<1.3cm o a success rate of stone 95.1% and 85.4%(p> 0.05), group D>1.3cm 85%and 62.9%(p<0.05). In group 1.0cm<D<1.3cm of the mechanical lithotripsy using a frequency of 4.9% and 50% (p <0.001), group D≥1.3cm 55% and 77.1%(p<0.05). Surgery, EPBD-EST group and EST group the occurrence of early postoperative complications was 22.2 and 22.9% (p>0.05),the occurrence of later postoperative complications was 8.6% and 9.6%(p > 0.05).In group 1.Ocm≤D<1.3cm of EPBD-EST group and EST group the occurrence of early postoperative complications was 19.5% and 14.6%(p> 0.05), the occurrence of later postoperative complications was 12.2% and 6.3%(p> 0.05). In group D>1.3cm of EPBD-EST group and EST group the occurrence of early postoperative complications was 25.0% and 34.2%(p> 0.05), the occurrence of later postoperative complications was 5.0% and 14.3%(p> 0.05). Both with no deaths.Conclusion:1.EST-EPBD compared with EST, low technical difficulty, simplify surgical procedures, simple operation, safety of operation, operation time shorten and efficiency is improve and reduce the suffering of patients.2.EST-EPBD not only enables papilla sphincter full expansion, but also retain some sphincter function, complete stone clearance rate is high, reducing the mechanical lithotripsy, reducing the number of repeated stone, especially suitable for the treatment of large common bile duct stones and multiple stones.3.EST-EPBD is a safe and effective method for the treatment of large common bile duct stones.