title: Short-term and long-term outcomes after endoscopic sphincterotomy versus endoscopic papillary balloon dilation for bile duct stones.
abstract: OBJECTIVE
  The aim of this study was to compare the short-term and long-term outcomes of endoscopic sphincterotomy (EST) with endoscopic papillary balloon dilation (EPBD), and to find out risk factors for long-term complications.
  
  
  METHODS
  From January 2008 to June 2011, patients who underwent endoscopic retrograde cholangiopancreatography for common bile duct stone removal were included, and they were divided into EST and EPBD groups. Clinical information was retrospectively viewed, and the patients were contacted through telephone or by searching for the medical records to get long-term outcomes.
  
  
  RESULTS
  A total of 863 patients were included, with 636 patients in the EST group and 227 patients in the EPBD group. There was no difference in the rate of complete stone removal and early complications, except for pancreatitis. In all, 493 patients in the EST group and 170 patients in the EST group were followed up for 36.7-77.6 months. More patients in the EST group developed cholangitis, stone recurrence, and cholecystitis in the long term. Multivariate analysis showed that EPBD was a protective factor for cholangitis, stone recurrence, and cholecystitis. Gall stones were risk factors for cholangitis and cholecystitis. Mechanical lithotripsy may also be a risk factor for stone recurrence.
  
  
  CONCLUSIONS
  EST shows better results in early outcomes, but during long-term follow-up patients following EST experienced more number of late complications. Gall stones and mechanical lithotripsy may be risk factors for long-term complications.
authors.affiliation: Digestive Endoscopy Center, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
authors.forename: Jia-Chuan
authors.initials: JC
authors.lastname: Wu
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.forename: Li-Ke
authors.initials: LK
authors.lastname: Bie
authors.forename: Biao
authors.initials: B
authors.lastname: Gong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D002761:Cholangitis / Q000209:etiology; D002764:Cholecystitis / Q000209:etiology; D042883:Choledocholithiasis / Q000175:diagnosis / Q000601:surgery*; D004106:Dilatation / Q000009:adverse effects; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010195:Pancreatitis / Q000209:etiology; D018579:Patient Selection; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult