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KMID : 0359020130460060637
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Korean Journal of Gastrointestinal Endoscopy
2013 Volume.46 No. 6 p.637 ~ p.642
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Late Complications and Stone Recurrence Rates after Bile Duct Stone Removal by Endoscopic Sphincterotomy and Large Balloon Dilation are Similar to Those after Endoscopic Sphincterotomy Alone
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Kim Ka-Young
Han Ji-Min
Kim Ho-Gak
Kim Byeong-Suk
Jung Jin-Tae
Kwon Joong-Goo
Kim Eun-Young
Lee Chang-Hyeong
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Abstract
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Background/Aims: Between endoscopic sphincterotomy (ES) alone and combined endoscopic sphincterotomy and large balloon dilation (ES-LBD) groups, efficacy and long-term complications, difference in biliary stone recurrence rate, and risk factors of stone recurrence were compared.
Methods: Medical records of 222 patients who underwent ERCP for biliary stone removal were retrospectively reviewed. Patients with dilated CBD ≥11 mm and follow-up longer than 6 months were included.
Results: There were 101 patients in ES-LBD group and 121 patients in ES group. Mean follow-up duration was 25.0 (6-48) months and 13.0 (6-43) months, respectively (p=0.001). There was no difference in number of ERCP sessions, brown pigment stones, angle between mid and distal common bile duct (CBD angle) <135°, and lithotripsy rate. Complete retrieval success rate was excellent in both groups (100% vs. 99%). Early complication rate of ES-LBD and ES alone group was 4 and 4.1%, respectively (p=1.000). One patient in ES-LBD group died from delayed bleeding. Late complication rate was 5.9 and 3.3%, respectively (p=1.000). Stone recurrence rate was 6.9% and 5.8%, respectively (p=0.984). The only Independent risk factor of stone recurrence was presence of periampullary diverticulum.
Conclusions: Late complication and stone recurrence rates were similar between ES-LBD and ES alone groups.
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KEYWORD
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Common bile duct stone, Sphincterotomy, endoscopic, Endoscopic large balloon dilation, Stone recurrence, Late complication
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