Application Of Small Endoscopic Sphincterotomy Combined With Large Balloon Dilation On Common Bile Duct Stones

Objective:To observe the efficacy of endoscopic sphincterotomy combined with large balloon dilatation in common bile duct stones.Methods:Patients with choledocholithiasis who were treated in our hospital from November 2015 to October 2017 were randomly divided into three groups: 52 cases with endoscopic small duodenal sphincterotomy combined with large balloon dilation Group(treatment group),49 cases of sphincterotomy group(control group A),49 cases of simple balloon dilatation group(control group B),statistics of three surgical methods in stone success rate of stone extraction,mechanical fragmentation Stone rate and the occurrence of postoperative complications were analyzed and compared using statistical methods.Results:There were no significant differences in mean age,sex ratio,average stone diameter,and mean stone count between the three groups(P>0.05).The number of successful stone removals in the three groups was 49,40,39 respectively.There was no significant difference betweenthe three groups the three groups groups(P>0.05).The number of cases requiring mechanical lithotripsy in the three groups was 5,12,and 15,respectively.There was a statistically significant difference between the three groups(P<0.05).There was a statistically significant difference in the incidence of total complications among the three groups(P<0.05),but there was no significant difference between the three groups in acute pancreatitis and hyperamylasemia(P>0.05).Only 3 cases of bleeding occurred in the EST group.Only 1 case of cholangitis occurred in the EPBD group.No perforation occurred in all three groups.In patients with stone diameter ≤15 mm,there were 28 patients in the treatment group,29 in the control group A,and 29 in the control group.There was no significant difference in the success rate of stone removal between the three groups and the incidence of recent complications(P>0.05).Diameters of stones ranging from 15 mm to 25 mm were found in 24 patients in the treatment group,22 in the control group,and 9 in the control group.There was no significant difference in the success rate of stone removal among three groups,acute pancreatitis,and perforation(P>0.05).There was a statistically significant difference in mechanical lithotripsy rate and bleeding(P<0.05).Conclusion:The use of endoscopic duodenal sphincter small incision combined with large balloon dilation for the treatment of common bile duct stones is safer and more effective,and the operation is easier.