Digestive Diseases and Sciences

, Volume 40, Issue 12, pp 2550–2554

Papillary dilation vs sphincterotomy in endoscopic removal of bile duct stones a randomized trial with manometric function

  • Atsushi Minami
  • Toshiaki Nakatsu
  • Naohito Uchida
  • Shuko Hirabayashi
  • Hiroki Fukuma
  • Syed Ahmed Morshed
  • Mikio Nishioka
Pancreatic and Biliary Disorders

DOI: 10.1007/BF02220440

Cite this article as:
Minami, A., Nakatsu, T., Uchida, N. et al. Digest Dis Sci (1995) 40: 2550. doi:10.1007/BF02220440

Abstract

To circumvent the long-term effects of papillary ablation for extracting common bile duct stones (<12 mm in diameter) in endoscopic sphincterotomy (EST), endoscopic papillary dilation (EPD) was attempted in 20 patients. To evaluate papillary function before and after the procedures, manometry of the sphincter of Oddi was carried out in 13 with EPD and 10 of 20 patients with EST. Extraction of all stones was successful (100%) in both groups at an equal rate. Repeated numbers of procedures were common in both groups. However, the mean duration of the procedure was high in EPD compared to EST (63 min vs 42 min,P<NS). Adjunctive therapies like mechanical lithotripsy (ML), nasobiliary drainage, and choledochoscopy were included in EPD, while EST required a basket catheter and ML. There was no significant difference on manometry before and after the procedures (P=NS), although papillary function was found to have decreased after the EPD. In contrast, all patients in the EST group lost papillary function after the procedure. Thirty-day morbidity and mortality rate were absent in both groups. Immediate and 2.5-year follow up complications were uncommon in both groups. As a simple method, EPD may be an effective and safe alternative to EST in the management of patients with bile duct stones who require maintenance of papillary function.

Key Words

papillary dilationsphincterotomymanometrybile duct stone

Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • Atsushi Minami
    • 1
  • Toshiaki Nakatsu
    • 1
  • Naohito Uchida
    • 1
  • Shuko Hirabayashi
    • 1
  • Hiroki Fukuma
    • 1
  • Syed Ahmed Morshed
    • 1
  • Mikio Nishioka
    • 1
  1. 1.Third Department of Internal MedicineKagawa Medical SchoolKagawaJapan