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Clin Endosc. 2013 Nov;46(6):637-42. doi: 10.5946/ce.2013.46.6.637. Epub 2013 Nov 19.

Late Complications and Stone Recurrence Rates after Bile Duct Stone Removal by Endoscopic Sphincterotomy and Large Balloon Dilation are Similar to Those after Endoscopic Sphincterotomy Alone.

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1
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

Abstract

BACKGROUND/AIMS:

Between endoscopic sphincterotomy (ES) alone and combined endoscopic sphincterotomy and large balloon dilation (ES-LBD) groups, efficacy and long-term complications, difference in biliary stone recurrence rate, and risk factors of stone recurrence were compared.

METHODS:

Medical records of 222 patients who underwent ERCP for biliary stone removal were retrospectively reviewed. Patients with dilated CBD ≥11 mm and follow-up longer than 6 months were included.

RESULTS:

There were 101 patients in ES-LBD group and 121 patients in ES group. Mean follow-up duration was 25.0 (6-48) months and 13.0 (6-43) months, respectively (p=0.001). There was no difference in number of ERCP sessions, brown pigment stones, angle between mid and distal common bile duct (CBD angle) <135°, and lithotripsy rate. Complete retrieval success rate was excellent in both groups (100% vs. 99%). Early complication rate of ES-LBD and ES alone group was 4 and 4.1%, respectively (p=1.000). One patient in ES-LBD group died from delayed bleeding. Late complication rate was 5.9 and 3.3%, respectively (p=1.000). Stone recurrence rate was 6.9% and 5.8%, respectively (p=0.984). The only Independent risk factor of stone recurrence was presence of periampullary diverticulum.

CONCLUSIONS:

Late complication and stone recurrence rates were similar between ES-LBD and ES alone groups.

KEYWORDS:

Common bile duct stone; Endoscopic large balloon dilation; Late complication; Sphincterotomy, endoscopic; Stone recurrence

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