Abstract
Background
Endoscopic papillary large balloon dilatation (EPLBD) is an effective technique in treating large common bile duct (CBD) stones. However, the efficacy and safety of EPLBD in the setting of periampullary diverticula (PAD) are prospectively lacking. This study aimed to compare the effectiveness and short-term safety of EPLBD after limited sphincterotomy with those of endoscopic sphincterotomy (EST) for extracting large CBD stones in the setting of PAD prospectively.
Methods
Forty-eight patients with large CBD stone(s) > 1 cm were recruited. All patients had a PAD. Before the procedure, patients were evaluated by history taking, clinical examination, full investigations including proper imaging studies. During the procedure, patients were randomized to either group I: patients treated with EPLBD after limited sphincterotomy, and group II: patients treated with EST. CBD clearance was defined as a single procedure (EPLBD vs EST), single session (no repeat ERCP), and non-assisted (no lithotripsy used) stone extraction. After the procedure, patients were hospitalized with clinical, laboratory, and imaging assessment.
Results
The overall stone extraction rate in the current study was only 77.3% (n = 34). The efficacy of stone extraction was significantly higher in the EPLBD (n = 21,87.5%) group compared to the EST (n = 13, 54.17%) group (p = 0.011). The procedure-related adverse events were lower in the EPLBD group compared to the EST group. Pancreatitis was significantly higher in the EST (n = 6, 25%) group than in the EPLBD (n = 1, 4.1%) group (p = 0.04). There was no significant difference between the two groups regarding postoperative bleeding and cholangitis. There were no perforations or case fatalities in either group.
Conclusion
Compared to EST, EPLBD is a more effective and safer method for extraction of large CBD stone(s) in the setting of PAD.
You have requested "on-the-fly" machine translation of selected content from our databases. This functionality is provided solely for your convenience and is in no way intended to replace human translation. Show full disclaimer
Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer
Details
1 Zagazig University, Hepatology, Gastroenterology, and Infectious Diseases Department, Faculty of Medicine, Zagazig, Egypt (GRID:grid.31451.32) (ISNI:0000 0001 2158 2757)
2 Suez University, Tropical Medicine Department, Faculty of Medicine, Suez, Egypt (GRID:grid.430657.3) (ISNI:0000 0004 4699 3087)
3 Kafrelsheikh University, Hepatology, Gastroenterology, and Infectious Diseases Department, Faculty of Medicine, Kafr El-Sheikh, Egypt (GRID:grid.411978.2) (ISNI:0000 0004 0578 3577); Alyousif Hospital, Medicine Department, Alkhobar, Saudi Arabia (GRID:grid.411978.2)