title: Endoscopic papillary balloon dilatation in comparison with endoscopic sphincterotomy for the treatment of large common bile duct stone.
abstract: BACKGROUND
  There are concerns on the efficacy and safety of endoscopic papillary balloon dilatation (EPBD) as an alternative to endoscopic sphincterotomy (EST) in the treatment of choledocholithiasis. We compared the efficacy and safety of EPBD and EST for removing large common bile duct (CBD) stones.
  
  
  METHODS
  One hundred sixty patients with CBD stones of 10-20 mm were randomized to undergo EPBD or EST. A 15-mm dilatation balloon was used for EPBD. Cotton's criteria were used to determine the incidence of post-EPBD or post-EST complications. CBD stone removal and complications were compared between the two methods.
  
  
  RESULTS
  CBD stones were completely removed in 97.5% of the EPBD and 96.2% of the EST group (P = 0.5). The incidence of postoperative pancreatitis (11.2% vs 8.7%) and bleeding (1.2% vs 1.2%) were similar between the EPBD and EST groups (P > 0.05). Perforation did not occur in any patient.
  
  
  CONCLUSIONS
  EPBD with 15-mm dilator balloon appears to be equally safe and effective compared with EST for removal of large CBD stones. So because of low complication and high success rate we recommend EPBD as the preferred method for removal of large (10-20 mm) CBD stones.
authors: Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Mahammad
authors: M
authors: Minakari
authors: Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Rahil R
authors: RR
authors: Samani
authors: Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Ahmad
authors: A
authors: Shavakhi
authors: Department of General Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Alireza
authors: A
authors: Jafari
authors: Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Neda
authors: N
authors: Alijanian
authors: Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Mehri
authors: M
authors: Hajalikhani
keywords: Choledocholithiasis; endoscopic papillary balloon dilatation; endoscopic sphincterotomy; pancreatitis