Skip to main content
Erschienen in: European Surgery 1/2017

01.02.2017 | Original Article

Small endoscopic sphincterotomy combined with endoscopic papillary large-balloon dilation in the treatment of patients with large bile duct stones

verfasst von: X. Chu, H. Zhang, R. Qu, G. Huang, C. Guo, F. Wang, M. Cheng, MD

Erschienen in: European Surgery | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Summary

Background

To compare the effectiveness and safety of the combination of endoscopic papillary large-balloon dilation (EPLBD) and small endoscopic sphincterotomy (SEST) with either EST or EPLBD alone in the treatment of large bile duct stones.

Methods

A total of 127 patients with large bile duct stones were enrolled and randomly divided into four treatment groups (the SEST + EPLBD group, the EPLBD + SEST group, the EST group, and the EPLBD group) in a 1:1:1:1 ratio. Evaluation variables included the success rates of complete stone removal, complete stone removal without the use of endoscopic mechanical lithotripsy (EML), and complete stone removal in one session, as well as the occurrence of short- and long-term postoperative complications.

Results

The overall rate of stone clearance was quite similar among the four treatment groups. There was no significant difference in the rate of complete stone removal without the use of EML among these groups. However, the combination treatment groups required relatively fewer sessions than did the EPLBD group. The incidence rates of short- and long-term complications were relatively lower in the two combination groups than in the EST and EPLBD groups.

Conclusions

A combination of SEST and EPLBD appears to be safe and effective for patients with large bile duct stones. This combination may have potential safety advantages in comparison with EST or EPLBD alone.
Literatur
1.
Zurück zum Zitat Kawai K, Akasaka Y, Murakami K, Tada M, Koli Y. Endoscopic sphincterotomy of the ampulla of Vater. Gastrointest Endosc. 1974;20(4):148–51.CrossRefPubMed Kawai K, Akasaka Y, Murakami K, Tada M, Koli Y. Endoscopic sphincterotomy of the ampulla of Vater. Gastrointest Endosc. 1974;20(4):148–51.CrossRefPubMed
2.
Zurück zum Zitat Classen M, Demling L. [Endoscopic sphincterotomy of the papilla of vater and extraction of stones from the choledochal duct (authorʼs transl)]. Dtsch Med Wochenschr. 1974;99(11):496–7.CrossRefPubMed Classen M, Demling L. [Endoscopic sphincterotomy of the papilla of vater and extraction of stones from the choledochal duct (authorʼs transl)]. Dtsch Med Wochenschr. 1974;99(11):496–7.CrossRefPubMed
3.
Zurück zum Zitat Cotton PB, Lehman G, Vennes J, Geenen JE, Russell RC, Meyers WC, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991;37(3):383–93.CrossRefPubMed Cotton PB, Lehman G, Vennes J, Geenen JE, Russell RC, Meyers WC, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991;37(3):383–93.CrossRefPubMed
4.
Zurück zum Zitat Boender J, Nix GA, de Ridder MA, van Blankenstein M, Schutte HE, Dees J, et al. Endoscopic papillotomy for common bile duct stones: factors influencing the complication rate. Endoscopy. 1994;26(2):209–16.CrossRefPubMed Boender J, Nix GA, de Ridder MA, van Blankenstein M, Schutte HE, Dees J, et al. Endoscopic papillotomy for common bile duct stones: factors influencing the complication rate. Endoscopy. 1994;26(2):209–16.CrossRefPubMed
5.
Zurück zum Zitat Leung JW, Chan FK, Sung JJ, Chung S. Endoscopic sphincterotomy-induced hemorrhage: a study of risk factors and the role of epinephrine injection. Gastrointest Endosc. 1995;42(6):550–4.CrossRefPubMed Leung JW, Chan FK, Sung JJ, Chung S. Endoscopic sphincterotomy-induced hemorrhage: a study of risk factors and the role of epinephrine injection. Gastrointest Endosc. 1995;42(6):550–4.CrossRefPubMed
6.
Zurück zum Zitat Yasuda I, Tomita E, Enya M, Kato T, Moriwaki H. Can endoscopic papillary balloon dilation really preserve sphincter of Oddi function? Gut. 2001;49(5):686–91.CrossRefPubMedPubMedCentral Yasuda I, Tomita E, Enya M, Kato T, Moriwaki H. Can endoscopic papillary balloon dilation really preserve sphincter of Oddi function? Gut. 2001;49(5):686–91.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Minami A, Nakatsu T, Uchida N, Hirabayashi S, Fukuma H, Morshed SA, et al. Papillary dilation vs sphincterotomy in endoscopic removal of bile duct stones. A randomized trial with manometric function. Dig Dis Sci. 1995;40(12):2550–4.CrossRefPubMed Minami A, Nakatsu T, Uchida N, Hirabayashi S, Fukuma H, Morshed SA, et al. Papillary dilation vs sphincterotomy in endoscopic removal of bile duct stones. A randomized trial with manometric function. Dig Dis Sci. 1995;40(12):2550–4.CrossRefPubMed
8.
Zurück zum Zitat Sato H, Kodama T, Takaaki J, Tatsumi Y, Maeda T, Fujita S, et al. Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry. Gut. 1997;41(4):541–4.CrossRefPubMedPubMedCentral Sato H, Kodama T, Takaaki J, Tatsumi Y, Maeda T, Fujita S, et al. Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry. Gut. 1997;41(4):541–4.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Li G, Pang Q, Zhang X, Dong H, Guo R, Zhai H, et al. Dilation-assisted stone extraction: an alternative method for removal of common bile duct stones. Dig Dis Sci. 2014;59(4):857–64.CrossRefPubMed Li G, Pang Q, Zhang X, Dong H, Guo R, Zhai H, et al. Dilation-assisted stone extraction: an alternative method for removal of common bile duct stones. Dig Dis Sci. 2014;59(4):857–64.CrossRefPubMed
10.
Zurück zum Zitat Zhao HC, He L, Zhou DC, Geng XP, Pan FM. Meta-analysis comparison of endoscopic papillary balloon dilatation and endoscopic sphincteropapillotomy. World J Gastroenterol. 2013;19(24):3883–91.CrossRefPubMedPubMedCentral Zhao HC, He L, Zhou DC, Geng XP, Pan FM. Meta-analysis comparison of endoscopic papillary balloon dilatation and endoscopic sphincteropapillotomy. World J Gastroenterol. 2013;19(24):3883–91.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Weinberg BM, Shindy W, Lo S. Endoscopic balloon sphincter dilation (sphincteroplasty) versus sphincterotomy for common bile duct stones. Cochrane Database Syst Rev. 2006;4:CD004890. Weinberg BM, Shindy W, Lo S. Endoscopic balloon sphincter dilation (sphincteroplasty) versus sphincterotomy for common bile duct stones. Cochrane Database Syst Rev. 2006;4:CD004890.
12.
Zurück zum Zitat Bergman JJ, Rauws EA, Fockens P, van Berkel AM, Bossuyt PM, Tijssen JG, et al. Randomised trial of endoscopic balloon dilation versus endoscopic sphincterotomy for removal of bileduct stones. Lancet. 1997;349(9059):1124–9.CrossRefPubMed Bergman JJ, Rauws EA, Fockens P, van Berkel AM, Bossuyt PM, Tijssen JG, et al. Randomised trial of endoscopic balloon dilation versus endoscopic sphincterotomy for removal of bileduct stones. Lancet. 1997;349(9059):1124–9.CrossRefPubMed
13.
Zurück zum Zitat Kim HG, Cheon YK, Cho YD, Moon JH, Park do H, Lee TH, et al. Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy. World J Gastroenterol. 2009;15(34):4298–304.CrossRefPubMedPubMedCentral Kim HG, Cheon YK, Cho YD, Moon JH, Park do H, Lee TH, et al. Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy. World J Gastroenterol. 2009;15(34):4298–304.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Heo JH, Kang DH, Jung HJ, Kwon DS, An JK, Kim BS, et al. Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct stones. Gastrointest Endosc. 2007;66(4):720–6 (quiz 68, 71).CrossRefPubMed Heo JH, Kang DH, Jung HJ, Kwon DS, An JK, Kim BS, et al. Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct stones. Gastrointest Endosc. 2007;66(4):720–6 (quiz 68, 71).CrossRefPubMed
15.
Zurück zum Zitat Hwang JC, Kim JH, Lim SG, Kim SS, Shin SJ, Lee KM, et al. Endoscopic large-balloon dilation alone versus endoscopic sphincterotomy plus large-balloon dilation for the treatment of large bile duct stones. BMC Gastroenterol. 2013;13:15.CrossRefPubMedPubMedCentral Hwang JC, Kim JH, Lim SG, Kim SS, Shin SJ, Lee KM, et al. Endoscopic large-balloon dilation alone versus endoscopic sphincterotomy plus large-balloon dilation for the treatment of large bile duct stones. BMC Gastroenterol. 2013;13:15.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Mu H, Gao J, Kong Q, Jiang K, Wang C, Wang A, et al. Prognostic factors and postoperative recurrence of calculus following small-incision sphincterotomy with papillary balloon dilation for the treatment of intractable choledocholithiasis: a 72-month follow-up study. Dig Dis Sci. 2015;60(7):2144–9.CrossRefPubMed Mu H, Gao J, Kong Q, Jiang K, Wang C, Wang A, et al. Prognostic factors and postoperative recurrence of calculus following small-incision sphincterotomy with papillary balloon dilation for the treatment of intractable choledocholithiasis: a 72-month follow-up study. Dig Dis Sci. 2015;60(7):2144–9.CrossRefPubMed
17.
Zurück zum Zitat Bang S, Kim MH, Park JY, Park SW, Song SY, Chung JB. Endoscopic papillary balloon dilation with large balloon after limited sphincterotomy for retrieval of choledocholithiasis. Yonsei Med J. 2006;47(6):805–10.CrossRefPubMedPubMedCentral Bang S, Kim MH, Park JY, Park SW, Song SY, Chung JB. Endoscopic papillary balloon dilation with large balloon after limited sphincterotomy for retrieval of choledocholithiasis. Yonsei Med J. 2006;47(6):805–10.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Kim TH, Oh HJ, Lee JY, Sohn YW. Can a small endoscopic sphincterotomy plus a large-balloon dilation reduce the use of mechanical lithotripsy in patients with large bile duct stones? Surg Endosc. 2011;25(10):3330–7.CrossRefPubMed Kim TH, Oh HJ, Lee JY, Sohn YW. Can a small endoscopic sphincterotomy plus a large-balloon dilation reduce the use of mechanical lithotripsy in patients with large bile duct stones? Surg Endosc. 2011;25(10):3330–7.CrossRefPubMed
19.
Zurück zum Zitat Kim JH, Yang MJ, Hwang JC, Yoo BM. Endoscopic papillary large balloon dilation for the removal of bile duct stones. World J Gastroenterol. 2013;19(46):8580–94.CrossRefPubMedPubMedCentral Kim JH, Yang MJ, Hwang JC, Yoo BM. Endoscopic papillary large balloon dilation for the removal of bile duct stones. World J Gastroenterol. 2013;19(46):8580–94.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Teoh AY, Cheung FK, Hu B, Pan YM, Lai LH, Chiu PW, et al. Randomized trial of endoscopic sphincterotomy with balloon dilation versus endoscopic sphincterotomy alone for removal of bile duct stones. Gastroenterology. 2013;144(2):341–5 e1.CrossRefPubMed Teoh AY, Cheung FK, Hu B, Pan YM, Lai LH, Chiu PW, et al. Randomized trial of endoscopic sphincterotomy with balloon dilation versus endoscopic sphincterotomy alone for removal of bile duct stones. Gastroenterology. 2013;144(2):341–5 e1.CrossRefPubMed
21.
Zurück zum Zitat Minami A, Hirose S, Nomoto T, Hayakawa S. Small sphincterotomy combined with papillary dilation with large balloon permits retrieval of large stones without mechanical lithotripsy. World J Gastroenterol. 2007;13(15):2179–82.CrossRefPubMedPubMedCentral Minami A, Hirose S, Nomoto T, Hayakawa S. Small sphincterotomy combined with papillary dilation with large balloon permits retrieval of large stones without mechanical lithotripsy. World J Gastroenterol. 2007;13(15):2179–82.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Freeman ML, Nelson DB, Sherman S, Haber GB, Herman ME, Dorsher PJ, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med. 1996;335(13):909–18.CrossRefPubMed Freeman ML, Nelson DB, Sherman S, Haber GB, Herman ME, Dorsher PJ, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med. 1996;335(13):909–18.CrossRefPubMed
23.
Zurück zum Zitat Sherman S, Ruffolo TA, Hawes RH, Lehman GA. Complications of endoscopic sphincterotomy. A prospective series with emphasis on the increased risk associated with sphincter of Oddi dysfunction and nondilated bile ducts. Gastroenterology. 1991;101(4):1068–75.CrossRefPubMed Sherman S, Ruffolo TA, Hawes RH, Lehman GA. Complications of endoscopic sphincterotomy. A prospective series with emphasis on the increased risk associated with sphincter of Oddi dysfunction and nondilated bile ducts. Gastroenterology. 1991;101(4):1068–75.CrossRefPubMed
24.
Zurück zum Zitat Mathuna PM, White P, Clarke E, Merriman R, Lennon JR, Crowe J. Endoscopic balloon sphincteroplasty (papillary dilation) for bile duct stones: efficacy, safety, and follow-up in 100 patients. Gastrointest Endosc. 1995;42(5):468–74.CrossRefPubMed Mathuna PM, White P, Clarke E, Merriman R, Lennon JR, Crowe J. Endoscopic balloon sphincteroplasty (papillary dilation) for bile duct stones: efficacy, safety, and follow-up in 100 patients. Gastrointest Endosc. 1995;42(5):468–74.CrossRefPubMed
25.
Zurück zum Zitat Baron TH, Harewood GC. Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: a metaanalysis of randomized, controlled trials. Am J Gastroenterol. 2004;99(8):1455–60.CrossRefPubMed Baron TH, Harewood GC. Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: a metaanalysis of randomized, controlled trials. Am J Gastroenterol. 2004;99(8):1455–60.CrossRefPubMed
26.
Zurück zum Zitat Ersoz G, Tekesin O, Ozutemiz AO, Gunsar F. Biliary sphincterotomy plus dilation with a large balloon for bile duct stones that are difficult to extract. Gastrointest Endosc. 2003;57(2):156–9.CrossRefPubMed Ersoz G, Tekesin O, Ozutemiz AO, Gunsar F. Biliary sphincterotomy plus dilation with a large balloon for bile duct stones that are difficult to extract. Gastrointest Endosc. 2003;57(2):156–9.CrossRefPubMed
27.
Zurück zum Zitat Fu BQ, Xu YP, Tao LS, Yao J, Zhou CS. Endoscopic papillary balloon intermittent dilatation and endoscopic sphincterotomy for bile duct stones. World J Gastroenterol. 2013;19(15):2425–32.CrossRefPubMedPubMedCentral Fu BQ, Xu YP, Tao LS, Yao J, Zhou CS. Endoscopic papillary balloon intermittent dilatation and endoscopic sphincterotomy for bile duct stones. World J Gastroenterol. 2013;19(15):2425–32.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Stefanidis G, Viazis N, Pleskow D, Manolakopoulos S, Theocharis L, Christodoulou C, et al. Large balloon dilation vs. mechanical lithotripsy for the management of large bile duct stones: a prospective randomized study. Am J Gastroenterol. 2011;106(2):278–85.CrossRefPubMed Stefanidis G, Viazis N, Pleskow D, Manolakopoulos S, Theocharis L, Christodoulou C, et al. Large balloon dilation vs. mechanical lithotripsy for the management of large bile duct stones: a prospective randomized study. Am J Gastroenterol. 2011;106(2):278–85.CrossRefPubMed
29.
Zurück zum Zitat Itoi T, Itokawa F, Sofuni A, Kurihara T, Tsuchiya T, Ishii K, et al. Endoscopic sphincterotomy combined with large balloon dilation can reduce the procedure time and fluoroscopy time for removal of large bile duct stones. Am J Gastroenterol. 2009;104(3):560–5.CrossRefPubMed Itoi T, Itokawa F, Sofuni A, Kurihara T, Tsuchiya T, Ishii K, et al. Endoscopic sphincterotomy combined with large balloon dilation can reduce the procedure time and fluoroscopy time for removal of large bile duct stones. Am J Gastroenterol. 2009;104(3):560–5.CrossRefPubMed
30.
Zurück zum Zitat Siqin D, Wang C, Zhou Z, Li Y. The key event of acute pancreatitis: pancreatic duct obstruction and bile reflux, not a single one can be omitted. Med Hypotheses. 2009;72(5):589–91.CrossRefPubMed Siqin D, Wang C, Zhou Z, Li Y. The key event of acute pancreatitis: pancreatic duct obstruction and bile reflux, not a single one can be omitted. Med Hypotheses. 2009;72(5):589–91.CrossRefPubMed
31.
Zurück zum Zitat Seo YR, Moon JH, Choi HJ, Kim DC, Ha JS, Lee TH, et al. Comparison of endoscopic papillary balloon dilation and sphincterotomy in young patients with CBD stones and gallstones. Dig Dis Sci. 2014;59(5):1042–7.CrossRefPubMed Seo YR, Moon JH, Choi HJ, Kim DC, Ha JS, Lee TH, et al. Comparison of endoscopic papillary balloon dilation and sphincterotomy in young patients with CBD stones and gallstones. Dig Dis Sci. 2014;59(5):1042–7.CrossRefPubMed
32.
Zurück zum Zitat Tanaka M, Takahata S, Konomi H, Matsunaga H, Yokohata K, Takeda T, et al. Long-term consequence of endoscopic sphincterotomy for bile duct stones. Gastrointest Endosc. 1998;48:465–9.CrossRefPubMed Tanaka M, Takahata S, Konomi H, Matsunaga H, Yokohata K, Takeda T, et al. Long-term consequence of endoscopic sphincterotomy for bile duct stones. Gastrointest Endosc. 1998;48:465–9.CrossRefPubMed
33.
Zurück zum Zitat Pereira-Lima JC, Jakobs R, Winter UH, Benz C, Martin WR, Adamek HE, et al. Long-term results (7 to 10 years) of endoscopic papillotomy for choledocholithiasis. Multivariate analysis of prognostic factors for the recurrence of biliary symptoms. Gastrointest Endosc. 1998;48:457–64.CrossRefPubMed Pereira-Lima JC, Jakobs R, Winter UH, Benz C, Martin WR, Adamek HE, et al. Long-term results (7 to 10 years) of endoscopic papillotomy for choledocholithiasis. Multivariate analysis of prognostic factors for the recurrence of biliary symptoms. Gastrointest Endosc. 1998;48:457–64.CrossRefPubMed
Metadaten
Titel
Small endoscopic sphincterotomy combined with endoscopic papillary large-balloon dilation in the treatment of patients with large bile duct stones
verfasst von
X. Chu
H. Zhang
R. Qu
G. Huang
C. Guo
F. Wang
M. Cheng, MD
Publikationsdatum
01.02.2017
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 1/2017
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-016-0388-2

Weitere Artikel der Ausgabe 1/2017

European Surgery 1/2017 Zur Ausgabe