BACKGROUND: Endoscopic sphincterotomy (ES) is widely performed in patients with common bile duct stones (CBDS). However, the long-term outcomes of patients following ES have not been sufficiently elucidated. Impaired papillary function following ES may result in additional late complications. In contrast, endoscopic papillary balloon dilation (EPBD)-another option for treating CBDS-is expected to preserve papillary function. This study aimed to compare the long-term outcomes of patients with CBDS treated with ES to those treated with EPBD in a large cohort. In addition, a subgroup analysis was performed, according to gallbladder (GB) status. METHODS: A cohort study was performed using propensity score matching to reduce treatment selection bias. This involved the analysis of follow-up data for 1086 patients who underwent EPBD or ES for CBDS. RESULTS: Propensity score matching extracted 246 pairs of patients. The median (interquartile range) follow-up period after EPBD or ES was 93.5 (46.8-129.2) months and 90 (42-139.3) months, respectively. The incidence of CBDS recurrence after EPBD and ES were 8.5 and 15.0 %, respectively. The hazard ratio (95 % CI) was 0.577 (0.338-0.986) (P = 0.044). Based on the status of the GB, the incidence of CBDS recurrence was significantly different between post-EPBD and post-ES in the group with cholecystectomy after EPBD/ES (P = 0.013). CONCLUSIONS: The incidence of biliary complications was significantly lower in patients after EPBD than in those after ES, and this outcome appeared most markedly in patients who also underwent cholecystectomy.
BACKGROUND: Endoscopic sphincterotomy (ES) is widely performed in patients with common bile duct stones (CBDS). However, the long-term outcomes of patients following ES have not been sufficiently elucidated. Impaired papillary function following ES may result in additional late complications. In contrast, endoscopic papillary balloon dilation (EPBD)-another option for treating CBDS-is expected to preserve papillary function. This study aimed to compare the long-term outcomes of patients with CBDS treated with ES to those treated with EPBD in a large cohort. In addition, a subgroup analysis was performed, according to gallbladder (GB) status. METHODS: A cohort study was performed using propensity score matching to reduce treatment selection bias. This involved the analysis of follow-up data for 1086 patients who underwent EPBD or ES for CBDS. RESULTS: Propensity score matching extracted 246 pairs of patients. The median (interquartile range) follow-up period after EPBD or ES was 93.5 (46.8-129.2) months and 90 (42-139.3) months, respectively. The incidence of CBDS recurrence after EPBD and ES were 8.5 and 15.0 %, respectively. The hazard ratio (95 % CI) was 0.577 (0.338-0.986) (P = 0.044). Based on the status of the GB, the incidence of CBDS recurrence was significantly different between post-EPBD and post-ES in the group with cholecystectomy after EPBD/ES (P = 0.013). CONCLUSIONS: The incidence of biliary complications was significantly lower in patients after EPBD than in those after ES, and this outcome appeared most markedly in patients who also underwent cholecystectomy.
Authors: J J Bergman; E A Rauws; P Fockens; A M van Berkel; P M Bossuyt; J G Tijssen; G N Tytgat; K Huibregtse Journal: Lancet Date: 1997-04-19 Impact factor: 79.321
Authors: Djemila Boerma; Erik A J Rauws; Yolande C A Keulemans; Ignace M C Janssen; Clemens J M Bolwerk; Ron Timmer; Egge J Boerma; Huug Obertop; Kees Huibregtse; Dirk J Gouma Journal: Lancet Date: 2002-09-07 Impact factor: 79.321
Authors: J C Pereira-Lima; R Jakobs; U H Winter; C Benz; W R Martin; H E Adamek; J F Riemann Journal: Gastrointest Endosc Date: 1998-11 Impact factor: 9.427
Authors: Dong Choon Kim; Jong Ho Moon; Hyun Jong Choi; A Reum Chun; Yun Nah Lee; Min Hee Lee; Tae Hoon Lee; Sang Woo Cha; Sang Gyune Kim; Young Seok Kim; Young Deok Cho; Sang-Heum Park; Hae Kyung Lee Journal: Dig Dis Sci Date: 2014-07-10 Impact factor: 3.199