Kim HG, Cheon YK, Cho YD, Moon JH, Park DH, Lee TH, Choi HJ, Park SH, Lee JS, Lee MS. Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy. World J Gastroenterol 2009; 15(34): 4298-4304 [PMID: 19750573 DOI: 10.3748/wjg.15.4298]
Corresponding Author of This Article
Young Koog Cheon, MD, PhD, Associate Professor, Institute for Digestive Research, Department of Internal Medicine, College of Medicine, Soonchunhyang University, 657 Hannam-Dong, Yongsan-Gu, Seoul 140-743, South Korea. cyk@hosp.sch.ac.kr
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World J Gastroenterol. Sep 14, 2009; 15(34): 4298-4304 Published online Sep 14, 2009. doi: 10.3748/wjg.15.4298
Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy
Hyun Gun Kim, Young Koog Cheon, Young Deok Cho, Jong Ho Moon, Do Hyun Park, Tae Hoon Lee, Hyun Jong Choi, Sang-Heum Park, Joon Seong Lee, Moon Sung Lee
Hyun Gun Kim, Young Koog Cheon, Young Deok Cho, Jong Ho Moon, Do Hyun Park, Tae Hoon Lee, Hyun Jong Choi, Sang-Heum Park, Joon Seong Lee, Moon Sung Lee, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul 140-743, South Korea
Author contributions: Kim HG and Cheon YK contributed equally to this work; Cheon YK designed the research; Kim HG, Cheon YK, Cho YD, Park DH and Choi HJ performed the research and collected the data; Kim HG analyzed the data; Cheon YK, Moon JH, Lee TH, Park SH, Lee JS and Lee MS reviewed the data analysis and corrected the research design; Kim HG wrote the paper; Cheon YK revised and corrected the paper.
Correspondence to: Young Koog Cheon, MD, PhD, Associate Professor, Institute for Digestive Research, Department of Internal Medicine, College of Medicine, Soonchunhyang University, 657 Hannam-Dong, Yongsan-Gu, Seoul 140-743, South Korea. cyk@hosp.sch.ac.kr
Telephone: +82-2-7099202 Fax: +82-2-7099696
Received: May 12, 2009 Revised: July 24, 2009 Accepted: July 31, 2009 Published online: September 14, 2009
Abstract
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.
