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KMID : 0359020070350020080
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Korean Journal of Gastrointestinal Endoscopy
2007 Volume.35 No. 2 p.80 ~ p.86
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The Safety and Effectiveness of Medium Endoscopic Sphincterotomy with Endoscopic Papillary Large Balloon Dilation for Removing Difficult Common Bile Duct Stones
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Lee Sun-Hae
Hong Sung-Wook
Cho Young Deok
Cheon Young-Koog
Kim Sang-Gyune
Jang Jae-Young
Kim Young-Seok
Moon Jong-Ho
Lee Joon-Seong
Lee Moon Sung
Shim Chan-Sup
Kim Boo-Sung
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Abstract
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Background/Aims:Mechanical lithotripsy is generally used when it is difficult to endoscopically remove common bile duct (CBD) stones. However, this procedure not only requires extensive experience, but it is also time consuming. Medium endoscopic sphincterotomy (medium EST) combined with endoscopic papillary large balloon dilation (EPLBD) is recently being increasingly used; therefore, the aim of this study was to evaluate the safety and effects of medium EST with EPLBD for patients with CBD stones that are difficult to remove.
Methods:41 patients with CBD stones that were difficult to remove by conventional endoscopic methods were enrolled in this study. EPLBD was performed after medium EST. The size of the stones, the procedure time, complications and the total number of sessions needed for stone removal were analyzed.
Results:The mean size of the CBD stones was 18.2 ? 7.7 mm, and the mean number of stones was 2.7. Additional mechanical lithotripsy for complete removal was required in 9.7% (4/41) of the patients. Procedure related complications occurred in 7% (3/41): bleeding in 1 case and acute pancreatitis in 2 cases.
Conclusions:Medium EST with EPLBD was a safe and effective treatment modality for CBD stones that were difficult to remove. Further prospective randomized studies are needed for comparing the effectiveness and safety between conventional EST and medium EST with EPLBD for removing difficult CBD stones.
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KEYWORD
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Endoscopic papillary large balloon dilation, Medium endoscopic sphincterotomy, Bile duct stones
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