Dilation-Assisted Stone Extraction: An Alternative Method for Removal of Common Bile Duct Stones
Dilation-assisted stone extraction, also termed small endoscopic sphincterotomy (EST) plus endoscopic papillary balloon dilatation, is more efficient than EST alone for removal of large common bile duct (CBD) stones. However, whether this technique can be used for all stones is unclear.
This study was designed to evaluate the efficacy and complications of dilation-assisted stone extraction for CBD stones.
A total of 462 patients with CBD stones were randomized to undergo either dilation-assisted stone extraction (group A) or EST (group B). The efficacy and complications of the two techniques were compared.
Groups A and B showed similar outcomes in terms of stone removal. The short-term and 1-year complication rates were also similar between the two groups. However, the first-session stone removal rate in group A was significantly higher than that in group B. Mechanical lithotripsy was required significantly more often in group B than in group A. The total procedure time and total fluoroscopy time in group A were significantly shorter than those in group B.
Dilation-assisted stone extraction and EST are safe and effective techniques for the treatment of CBD stones. Dilation-assisted stone extraction has high efficiency. This technique is an alternative method for removal of CBD stones.
KeywordsEndoscopic sphincterotomy Choledocholithiasis Endoscopic retrograde cholangiopancreatography Lithotripsy
We are indebted to Zilong Lu of the Shandong Center for Disease Control and Prevention for his help with the statistical data analysis.
Conflict of interest
- 6.Minami A, Nakatsu T, Uchida N, et al. Papillary dilatation vs sphincterotomy in endoscopic removal of bile duct stones. A randomized trial with manometric function. Dig Dis Sci. 1995;40:2550–2554.Google Scholar