title: Small Endoscopic Sphincterotomy plus Large-Balloon Dilation for Removal of Large Common Bile Duct Stones during ERCP.
abstract: OBJECTIVE
  This study compared the therapeutic benefits and complication rates of small endoscopic sphincterotomy plus large-balloon dilation (ESLBD) with those of endoscopic sphincterotomy (EST) alone for large bile duct stones.
  
  
  METHODS
  We compared prospectively ESLBD group (n=63) with conventional EST group (n=69) for the treatment of large bile duct stones (≥15mm). Mechanical lithotripsy was performed when the stone could not be removed using a normal basket. We compared the rates of stone removal, frequency of mechanical lithotripsy use, procedure-related complications, and recurrent stones.
  
  
  RESULTS
  A total of 132 patients were reviewed in the study. The mean age of the patients was 67.9 years. The two groups showed significant differences in complete stone removal during the first session (80.9 vs. 60.8%; P = 0.046), the use of mechanical lithotripsy (7.94 vs. 24.6%; P = 0.041), and less duration of admission (P =0.045). After ERCP, there were some instances of oozing in both groups, All patients recovered completely, 14 patients had recurrent common bile duct stones among the follow-up duration.
  
  
  CONCLUSIONS
  The ESLBD technique seems to be a feasible and safe alternative technique for conventional EST and EBD and has no more Post-ERCP complications.
authors.affiliation: Qian Jun Bo, Department of Gastroenterology, The First People's Hospital of Nantong, Nantong, China 226001.
authors.forename: Qian
authors.initials: Q
authors.lastname: Jun Bo
authors.affiliation: Xu Li Hua, Department of Gastroenterology, The First People's Hospital of Nantong, Nantong, China 226001.
authors.forename: Xu
authors.initials: X
authors.lastname: Li Hua
authors.affiliation: Chen Tian Min, Department of Gastroenterology, The First People's Hospital of Nantong, Nantong, China 226001.
authors.forename: Chen
authors.initials: C
authors.lastname: Tian Min
authors.affiliation: Gu Liu Gen, Department of Gastroenterology, The First People's Hospital of Nantong, Nantong, China 226001.
authors.forename: Gu
authors.initials: G
authors.lastname: Liu Gen
authors.affiliation: Yang Yan Mei, Department of Gastroenterology, The First People's Hospital of Nantong, Nantong, China 226001.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yan Mei
authors.affiliation: Lu Hua Sheng, Department of Gastroenterology, The First People's Hospital of Nantong, Nantong, China 226001.
authors.forename: Lu
authors.initials: L
authors.lastname: Hua Sheng
keywords: Common bile duct stones; Endoscopic retrograde cholangiopancreatography; Endoscopic sphincterotomy; Mechanical lithotripsy; Small endoscopic sphincterotomy plus large-balloon dilation