BACKGROUND: This study was designed to evaluate the therapeutic outcome and early postoperative complications, especially pancreatitis, of endoscopic papillary balloon dilation (EPBD) and endoscopic sphincterotomy (EST) in patients with common bile duct stones in our department. METHODS:One hundred eighty patients with common bile duct stones were randomized to undergo EPBD or EST. An 8-mm dilatation balloon was used for EPBD. Modified Cotton's criteria, in which relatively mild pancreatitis is also included as a complication, were used to determine the incidence of postoperative complications. RESULTS: The rate of complete removal of stones was significantly higher in the EST group (95.6%) than in the EPBD group (86.6%); for stones less than 10 mm in diameter, however, the rate with EPBD (93.8%) was almost equivalent to that with EST (98.1%). According to modified Cotton's criteria, the incidence of postoperative pancreatitis was significantly higher in the EPBD group (16.7%) than in the EST group (6.7%). Bleeding was encountered in one patient (1.1%) in the EST group, but in none in the EPBD group. No fatal complication occurred in either the EPBD or the EST group. CONCLUSIONS: Although EPBD appears to be comparable to EST for removal of small common bile duct stones, mild postoperative pancreatitis is more likely to occur with EPBD than with EST.
RCT Entities:
BACKGROUND: This study was designed to evaluate the therapeutic outcome and early postoperative complications, especially pancreatitis, of endoscopic papillary balloon dilation (EPBD) and endoscopic sphincterotomy (EST) in patients with common bile duct stones in our department. METHODS: One hundred eighty patients with common bile duct stones were randomized to undergo EPBD or EST. An 8-mm dilatation balloon was used for EPBD. Modified Cotton's criteria, in which relatively mild pancreatitis is also included as a complication, were used to determine the incidence of postoperative complications. RESULTS: The rate of complete removal of stones was significantly higher in the EST group (95.6%) than in the EPBD group (86.6%); for stones less than 10 mm in diameter, however, the rate with EPBD (93.8%) was almost equivalent to that with EST (98.1%). According to modified Cotton's criteria, the incidence of postoperative pancreatitis was significantly higher in the EPBD group (16.7%) than in the EST group (6.7%). Bleeding was encountered in one patient (1.1%) in the EST group, but in none in the EPBD group. No fatal complication occurred in either the EPBD or the EST group. CONCLUSIONS: Although EPBD appears to be comparable to EST for removal of small common bile duct stones, mild postoperative pancreatitis is more likely to occur with EPBD than with EST.
Authors: James A Disario; Martin L Freeman; David J Bjorkman; Padraic Macmathuna; Bret T Petersen; Philip E Jaffe; Thomas G Morales; Lee J Hixson; Stuart Sherman; Glen A Lehman; M Mazen Jamal; Firas H Al-Kawas; Mukul Khandelwal; Joseph P Moore; Gregory A Derfus; Priya A Jamidar; Francisco C Ramirez; Michael E Ryan; Karen L Woods; David L Carr-Locke; Stephen C Alder Journal: Gastroenterology Date: 2004-11 Impact factor: 22.682
Authors: D Vaira; L D'Anna; C Ainley; J Dowsett; S Williams; J Baillie; S Cairns; J Croker; P Salmon; P Cotton Journal: Lancet Date: 1989-08-19 Impact factor: 79.321
Authors: Do Hyun Park; Myung-Hwan Kim; Sung Koo Lee; Sang Soo Lee; Jung Sik Choi; Moon Hee Song; Dong Wan Seo; Young Il Min Journal: Gastrointest Endosc Date: 2004-08 Impact factor: 9.427
Authors: Byoung Wook Bang; Seok Jeong; Don Haeng Lee; Jung Il Lee; Jin-Woo Lee; Kye Sook Kwon; Hyung Gil Kim; Yong Woon Shin; Young Soo Kim Journal: Korean J Intern Med Date: 2010-08-31 Impact factor: 2.884