摘要
AIM:To compare small sphincterotomy combined with endoscopic papillary large balloon dilation(SES+ ELBD)and endoscopic sphincterotomy(EST)for large bile duct stones. METHODS:We compared prospectively SES+ELBD (group A,n=27)with conventional EST(group B, n=28)for the treatment of large bile duct stones(≥ 15 mm).When the stone could not be removed with a normal basket,mechanical lithotripsy was performed. We compared the rates of complete stone removal with one session and application of mechanical lithotripsy. RESULTS:No significant differences were observed in the mean largest stone size(A:20.8 mm,B:21.3 mm), bile duct diameter(A:21.4 mm,B:20.5 mm),number of stones(A:2.2,B:2.3),or procedure time(A:18 min, B:19 min)between the two groups.The rates of complete stone removal with one session was 85%in group A and 86%in group B(P=0.473).Mechanical lithotripsy was required for stone removal in nine of 27 patients(33%)in group A and nine of 28 patients (32%,P=0.527)in group B.CONCLUSION:SES+ELBD did not show significant benefits compared to conventional EST,especially for the removal of large(≥15 mm)bile duct stones.
AIM: To compare small sphincterotomy combined with endoscopic papillary large balloon dilation (SES + ELBD) and endoscopic sphincterotomy (EST) for large bile duct stones. METHODS: We compared prospectively SES + ELBD (group A, n = 27) with conventional EST (group B, n = 28) for the treatment of large bile duct stones (≥ 15 mm). When the stone could not be removed with a normal basket, mechanical lithotripsy was performed. We compared the rates of complete stone removal with one session and application of mechanical lithotripsy. RESULTS: No significant differences were observed in the mean largest stone size (A: 20.8 mm, B: 21.3 mm), bile duct diameter (A: 21.4 turn, B: 20.5 ram), number of stones (A: 2.2, B: 2.3), or procedure time (A: 18 min, B: 19 rain) between the two groups. The rates of complete stone removal with one session was 85% in group A and 86% in group B (P = 0.473). Mechanical lithotripsy was required for stone removal in nine of 27 patients (33%) in group A and nine of 28 patients (32%, P = 0.527) in group B.CONCLUSION: SES + ELBD did not show significant benefits compared to conventional EST, especially for the removal of large (≥ 15 mm) bile duct stones.
关键词
括约肌
乳头
球囊
胆管
EST
结石
局长
经济
Sphincterotomy
Endoscopic
Balloon dilatation
Cholelithiasis
Lithotripsy