title: [Endoscopic papillary balloon dilatation vs. endoscopic  sphincteropapillotomy for common bile duct  stones: a meta analysis].
abstract: OBJECTIVE
  To evaluate the safety and efficacy between endoscopic papillary balloon dilatation (EPBD) and endoscopic sphincteropapillotomy ( EST) for common bile duct stones using meta-analysis method.
  
  
  METHODS
  Randomizd controlled trials comparing EPBD with EST for common bile duct stones and published from January 1990 to July 2012 were recruited. This meta-analysis was conducted to estimate short-term and long-term complications. Fixed random effect model or random effect model was established to analyze the data.
  
  
  RESULTS
  Twelve randomizd controlled trials were included in this analysis. These studies included 1865 patients, 925 of them were treated with EPBD and 940 were treated with EST. The analysis of basic characteristics of these included studies showed that: compared to EST, patients in the EPBD group were younger (OR = -1.16, 95% CI: -1.49 to -0.84, P = 0.00), while in two groups, there were no significant difference (P > 0.05) in gender proportion, average size of stones, number of gallstones, previous cholecystectomy, the number of merged duodenal diverticulum, common bile duct diameter, the total follow-up time. Also, compared to EST, the overall stone clearance in the EPBD group was lower (OR = 0.64, 95% CI: 0.42 to 0.96, P = 0.03), pancreatitis incidence was higher (OR = 2.67, 95% CI: 1.61 to 4.43, P = 0.00), incidence of bleeding (OR = 0.12, 95% CI: 0.04 to 0.34, P = 0.00), acute cholecystitis (OR= 0.39, 95% CI: 0.18 to 0.84, P = 0.02), total long-term complication rate (OR = 0.53, 95% CI: 0.36 to 0.77, P = 0.01), stone recurrence rate more than a year were lower (OR= 0.48, 95% CI: 0.26 to 0.90, P = 0.02). While in two groups, there were no significant difference (P > 0.05) in the stone removal on 1 '' attempt, the total near-term complications and acute cholangitis.
  
  
  CONCLUSIONS
  On the basis of lower rates of bleeding, EPBD seems to be preferred strategy over EST for endoscopic remove of common bile duct stones in patients who have coagulopathy. Although stone recurrence rate more than a year of EPBD is lower, but the overall stone clearance rate is lower and the risk of pancreatitis is higher than that of EST.
authors.forename: Liang
authors.initials: L
authors.lastname: He
authors.forename: Xiao-ping
authors.initials: XP
authors.lastname: Geng
authors.forename: Hong-chuan
authors.initials: HC
authors.lastname: Zhao
authors.forename: Da-chen
authors.initials: DC
authors.lastname: Zhou
authors.forename: Fu-bao
authors.initials: FB
authors.lastname: Liu
authors.forename: Yi-jun
authors.initials: YJ
authors.lastname: Zhao
authors.forename: Guo-bin
authors.initials: GB
authors.lastname: Wang
authors.forename: Zhi-gong
authors.initials: ZG
authors.lastname: Zhang
authors.forename: Fan
authors.initials: F
authors.lastname: Huang
mesh_terms: D004106:Dilatation; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome