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Small endoscopic sphincterotomy combined with endoscopic papillary large-balloon dilation in the treatment of patients with large bile duct stones

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Summary

Background

To compare the effectiveness and safety of the combination of endoscopic papillary large-balloon dilation (EPLBD) and small endoscopic sphincterotomy (SEST) with either EST or EPLBD alone in the treatment of large bile duct stones.

Methods

A total of 127 patients with large bile duct stones were enrolled and randomly divided into four treatment groups (the SEST + EPLBD group, the EPLBD + SEST group, the EST group, and the EPLBD group) in a 1:1:1:1 ratio. Evaluation variables included the success rates of complete stone removal, complete stone removal without the use of endoscopic mechanical lithotripsy (EML), and complete stone removal in one session, as well as the occurrence of short- and long-term postoperative complications.

Results

The overall rate of stone clearance was quite similar among the four treatment groups. There was no significant difference in the rate of complete stone removal without the use of EML among these groups. However, the combination treatment groups required relatively fewer sessions than did the EPLBD group. The incidence rates of short- and long-term complications were relatively lower in the two combination groups than in the EST and EPLBD groups.

Conclusions

A combination of SEST and EPLBD appears to be safe and effective for patients with large bile duct stones. This combination may have potential safety advantages in comparison with EST or EPLBD alone.

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Acknowledgments

All authors would like to thank Rebekah Burdyshaw, Cleveland State University, for her critical proofreading of the manuscript.

Source of funding

None.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Yantai Yeda Hospital, Yantai, Shandong Province, China

    X. Chu & F. Wang

  2. Department of Internal Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong Province, China

    H. Zhang

  3. Department of Surgery, Yantai Yeda Hospital, No. 11 Mountain Tai Road, 264006, Yantai, Shandong Province, China

    R. Qu & M. Cheng MD

  4. Department of Obstetrics and Gynecology, Yantai Yeda Hospital, Yantai, Shandong Province, China

    G. Huang

  5. Department of Surgical Nursing, Yantai Yeda Hospital, Yantai, Shandong Province, China

    C. Guo

Authors
  1. X. Chu
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  2. H. Zhang
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  3. R. Qu
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  4. G. Huang
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  5. C. Guo
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  6. F. Wang
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  7. M. Cheng MD
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Corresponding author

Correspondence to M. Cheng MD.

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Conflict of interest

All authors declare they have no conflict of interest regarding the current study.

The study protocol was approved by the institutional ethics committee and all participants provided informed written consent.

Additional information

X. Chu, H. Zhang, R. Qu, G. Huang and C. Guo are co-first authors who contributed equally to this study.

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Chu, X., Zhang, H., Qu, R. et al. Small endoscopic sphincterotomy combined with endoscopic papillary large-balloon dilation in the treatment of patients with large bile duct stones. Eur Surg 49, 9–16 (2017). https://doi.org/10.1007/s10353-016-0388-2

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  • DOI: https://doi.org/10.1007/s10353-016-0388-2

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