Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct stones

被引：212
作者：
Heo, Jeung Ho [1 ]
Kang, Dae Hwan [1 ]
Jung, Hyo Jin [1 ]
Kwon, Dae Sik [1 ]
An, Jin Kwang [1 ]
Kim, Bo Suk [1 ]
Suh, Kyung Duk [1 ]
Lee, Sang Yong [1 ]
Lee, Joo Ho [1 ]
Kim, Gwang Ha [1 ]
Kim, Tae Oh [1 ]
Heo, Jeong [1 ]
Song, Geun Am [1 ]
Cho, Mong [1 ]
机构：
[1] Pusan Natl Univ, Coll Med, Dept Internal Med, Pusan 602739, South Korea
来源：
GASTROINTESTINAL ENDOSCOPY | 2007年 / 66卷 / 04期
关键词：
D O I：
10.1016/j.gie.2007.02.033
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
Background: Endoscopic sphincterotomy (EST) to remove bile-duct stones is the most frequently used endoscopic technique. Few reports exist regarding application of large-balloon dilation (LBD) after EST for treatment of patients with bile-duct stones. Objective: To compare the effect of EST plus LBD with that of EST alone. Design: A prospective randomized controlled trial. Setting: A large tertiary-referral center. Patients and interventions: Two hundred consecutive patients with bile-duct stones were randomized in equal numbers to EST plus LBD (12- to 20-mm balloon diameter) or EST alone. Main Outcome Measurements: Successful stone removal and complications such as pancreatitis and bleeding. Results: EST plus LBD compared with EST alone resulted in similar outcomes in terms of overall successful stone removal (97.0% vs 98.0%), large size (> 15 mm) stone removal (94.4% vs 96.7%), and the use of mechanical lithotripsy (8.0% vs 9.0%). Complications were similar between the 2 groups (5.0% vs 7.0%, P = .767). Complications were as follows for the EST plus LBD group and the EST group: pancreatitis, 4.0% and 4.0%; cholecystitis, 1.0% and 1.0%; and bleeding (delayed), 0% and 2.0%, respectively Conclusions: Based on the similar rates of successful stone removal and complications, EST plus LBD should be an effective alternative to EST EST plus LBD is a safe and effective treatment for endoscopic removal of common bile duct stones.
引用
收藏
页码：720 / 726
页数：7
相关论文
共 32 条
[1]   Endoscopic papillary balloon dilation vs. sphincterotomy for removal of common bile duct stones: A prospective randomized pilot study [J].
Arnold, JC ;
Benz, C ;
Martin, WR ;
Adamek, HE ;
Riemann, JF .
ENDOSCOPY, 2001, 33 (07) :563-567
[2]   Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: A metaanalysis of randomized, controlled trials [J].
Baron, TH ;
Harewood, GC .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2004, 99 (08) :1455-1460
[3]   Randomised trial of endoscopic balloon dilation versus endoscopic sphincterotomy for removal of bileduct stones [J].
Bergman, JJGHM ;
Rauws, EAJ ;
Fockens, P ;
vanBerkel, AM ;
Bossuyt, PMM ;
Tijssen, JGP ;
Tytgat, GNJ ;
Huibregtse, K .
LANCET, 1997, 349 (9059) :1124-1129
[4]   Long-term follow-up after endoscopic sphincterotomy for bile duct stones in patients younger than 60 years of age [J].
Bergman, JJGHM ;
vanderMey, S ;
Rauws, EAJ ;
Tijssen, JGP ;
Gouma, DJ ;
Tytgat, GNJ ;
Huibregtse, K .
GASTROINTESTINAL ENDOSCOPY, 1996, 44 (06) :643-649
[5]   Combined Endoscopic Biliary Sphincterotomy and Large Balloon Dilation for Large Common Bile Duct Stones [J].
Carnes, Matthew ;
Cotton, Peter B. ;
Hawes, Robert H. ;
Lawrence, Christopher ;
Payne, Mark ;
Romagnuolo, Joseph .
GASTROINTESTINAL ENDOSCOPY, 2006, 63 (05) :AB287-AB287
[6]   ENDOSCOPIC SPHINCTEROTOMY OF PAPILLA OF VATER AND EXTRACTION OF STONES FROM CHOLEDOCHAL DUCT [J].
CLASSEN, M ;
DEMLING, L .
DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT, 1974, 99 (11) :496-497
[7]   ENDOSCOPIC SPHINCTEROTOMY COMPLICATIONS AND THEIR MANAGEMENT - AN ATTEMPT AT CONSENSUS [J].
COTTON, PB ;
LEHMAN, G ;
VENNES, J ;
GEENEN, JE ;
RUSSELL, RCG ;
MEYERS, WC ;
LIGUORY, C ;
NICKL, N .
GASTROINTESTINAL ENDOSCOPY, 1991, 37 (03) :383-393
[8]   Endoscopic balloon dilation compared with sphincterotomy for extraction of bile duct stones [J].
DiSario, JA ;
Freeman, ML ;
Bjorkman, DJ ;
MacMathuna, P ;
Petersen, BT ;
Jaffe, PE ;
Morales, TG ;
Hixson, LJ ;
Sherman, S ;
Lehman, GA ;
Jamal, MM ;
Al-Kawas, FH ;
Khandelwal, M ;
Moore, JP ;
Derfus, GA ;
Jamidar, PA ;
Ramirez, FC ;
Ryan, ME ;
Woods, KL ;
Carr-Locke, DL ;
Alder, SC .
GASTROENTEROLOGY, 2004, 127 (05) :1291-1299
[9]   Biliary sphincterotomy plus dilation with a large balloon for bile duct stones that are difficult to extract [J].
Ersoz, G ;
Tekesin, O ;
Ozutemiz, AO ;
Gunsar, F .
GASTROINTESTINAL ENDOSCOPY, 2003, 57 (02) :156-159
[10]   Large Size Balloon Dilation of the Ampulla After Biliary Sphincterotomy Can Facilitate Endoscopic Extraction of Complicated Bile Duct Stones [J].
Evans, William B. ;
Draganov, Peter ;
Forsmark, Chris .
GASTROINTESTINAL ENDOSCOPY, 2006, 63 (05) :AB283-AB283
1234