title: Endoscopic papillary balloon intermittent dilatation and endoscopic sphincterotomy for bile duct stones.
abstract: OBJECTIVE
  To compare the effectiveness and safety of endoscopic papillary balloon intermittent dilatation (EPBID) and endoscopic sphincterotomy (EST) in the treatment of common bile duct stones.
  
  
  METHODS
  From March 2011 to May 2012, endoscopic retrograde cholangiopancreatography was performed in 560 patients, 262 with common bile duct stones. A total of 206 patients with common bile duct stones were enrolled in the study and randomized to receive either EPBID with a 10-12 mm dilated balloon or EST (103 patients in each group). For both groups a conventional reticular basket or balloon was used to remove the stones. After the procedure, routine endoscopic nasobiliary drainage was performed.
  
  
  RESULTS
  First-time stone removal was successfully performed in 94 patients in the EPBID group (91.3%) and 75 patients in the EST group (72.8%). There was no statistically significant difference in terms of operation time between the two groups. The overall incidence of early complications in the EPBID and EST groups was 2.9% and 13.6%, respectively, with no deaths reported during the course of the study and follow-up. Multiple regression analysis showed that the success rate of stone removal was associated with stone removal method [odds ratio (OR): 5.35; 95%CI: 2.24-12.77; P = 0.00], the transverse diameter of the stone (OR: 2.63; 95%CI: 1.19-5.80; P = 0.02) and the presence or absence of diverticulum (OR: 2.35; 95%CI: 1.03-5.37; P = 0.04). Postoperative pancreatitis was associated with the EST method of stone removal (OR: 5.00; 95%CI: 1.23-20.28; P = 0.02) and whether or not pancreatography was performed (OR: 0.10; 95%CI: 0.03-0.35; P = 0.00).
  
  
  CONCLUSIONS
  The EPBID group had a higher success rate of stone removal with a lower incidence of pancreatitis compared with the EST group.
authors.affiliation: Department of Gastroenterology, the People's Hospital, Affiliated to Jiangsu University, Zhenjiang 212002, Jiangsu Province, China.
authors.forename: Bai-Qing
authors.initials: BQ
authors.lastname: Fu
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Xu
authors.forename: Li-Sheng
authors.initials: LS
authors.lastname: Tao
authors.forename: Jun
authors.initials: J
authors.lastname: Yao
authors.forename: Chun-Suo
authors.initials: CS
authors.lastname: Zhou
mesh_terms: D000368:Aged; D001652:Bile Ducts / Q000473:pathology; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000379:methods*; D004106:Dilatation / Q000379:methods*; D004322:Drainage; D005260:Female; D042882:Gallstones / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010195:Pancreatitis / Q000175:diagnosis; D011183:Postoperative Complications / Q000175:diagnosis; D011184:Postoperative Period; D012044:Regression Analysis; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Common bile duct stones; Endoscopic papillary balloon dilatation; Endoscopic retrograde cholangiopancreatography; Endoscopic sphincterotomy; Success rate