Clinical Analysis Of Limited Endoscopic Sphincterotomy Plus Balloon Dilation For The Treatment Of Common Bile Duct Stones

Objective To analyse the effects of endoscopic sphincterotomy(EST),endoscopic papillary balloon dilation(EPBD)and limited endoscopic sphincterotomy plus balloon dilation(ESBD)on common bile duct stones.Methods A total of 398 patients with common bile duct stones treated in Renji Hospital from Jul.2011 to Jul.2014 were divided into three groups: endoscopic sphincterotomy group(EST group,n=228),endoscopic papillary balloon dilation group(EPBD group,n=36)and limited endoscopic sphincterotomy plus balloon dilation group(ESBD group,n=134).The differences of stones diameter,success rate of stone removal,postoperative short-term(24 h)blood amylase level and the short-term(1 week postoperatively)complications such as pancreatitis,bleeding,perforation,biliary tract infection and long-term(2 years postoperatively)complications such as reflux cholangitis,stones recurrence,hospitalization stays,total expenses,were compared among three groups.Results There were no significant difference in gender,age,stone removal rates and hospitalization stays among three groups(P>0.05).Compared with that of the EST group and the EPBD group,the average maximum diameter of stones in ESBD group was biggest(P<0.05).In term of short-term complications,EPBD group had the highest incidence of pancreatitis among three groups(P<0.05);there was no significant difference in hyperamylasemia,bleeding,perforation and biliary tract infection among three groups(P > 0.05).In term of long-term complications,there was no significant difference in reflux cholangitis among three groups(P>0.05),however,ESBD group had lower stone recurrence rate than EST group(P<0.05).Compared with the EST group,there were higher hospitalization expenses in EPBD group and ESBD group,which is highest in ESBD group(P<0.05).Conclusion ESBD is safer and more effective than EST and EPBD for the treatment of common bile duct stones.