Endoscopic sphincterotomy and papillary balloon dilation for bile duct stones.
OBJECTIVE
There are many reports of the results of endoscopic sphincterotomy (EST) for common bile duct stones. Recently, there were several reports on the results of endoscopic papillary balloon dilation (EPBD) for this condition. However, there have been few reports about a comparison between EST and EPBD.


METHODS
Between Oct. 1994 and Dec. 1998, 196 consecutive patients underwent 102 EST or 94 EPBD.


RESULTS
EST and EPBD were successful in 100 of 102 (98.0%), and all 94 patients. Bile duct clearance was achieved in 88 (88.0%) in the EST group and 88 (95.7%) in the EPBD group. Early complications occurred in 13 (13.0%: 3 acute pancreatitis, 4 cholangitis, 2 cholecystitis, 2 bleeding, 2 perforation) in the EST group and 16 (17.0%: 7 acute pancreatitis, 4 cholangitis, 4 cholecystitis, 1 basket impaction) in the EPBD group. Three patients (1 bleeding, 2 perforations) underwent emergent surgery after EST.


CONCLUSIONS
The rate of bile duct clearance with EPBD was comparable to that with EST. Early complications did not differ between EST and EPBD. The use of EST tended to be associated with a lower incidence of acute pancreatitis, a higher incidence of bleeding, and a higher rate of perforation.
Toda
Nobuo
N
Division of Gastroenterology, Kameda General Hospital, University Of Tokyo, Japan. toda-2im@h.u-tokyo.ac.jp
Saito
Keiji
K
Wada
Ryou
R
Kawabe
Takao
T
Shiratori
Yasushi
Y
Mitsushima
Toru
T
Omata
Masao
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery; D002404:Catheterization / Q000379:methods*; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016717:Sphincterotomy, Endoscopic / Q000379:methods*