Clinical application of endoscopic sphincterotomy in combination with endoscoopic papillary balloon dilatation in the treatment of common bile duct stones

Objective To investigate the clinical value of endoscopic sphincterotomy (EST) in combination with endoscoopic papillary balloon dilatation (EPBD) in the treatment of common bile duct stones. Methods Endoscopic retrograde cholangio pancreatography (ERCP) was performed in 160 cases of common bile duct stones in our hospital between January, 2014 and June, 2016. The patients in EST group (n=80) received EST, while the patients in EST+EPBD group (n=80) received EST and EPBD. The operation time, intraoperative blood loss, the success rate of lithotomy and the incidence of postoperative complications were compared between the two groups. Results Compared with EST group, postoperative bleeding, acute pancreatitis and hyperamylasemia, biliary tract infection, postoperative pain, postoperative complications and the total complications decreased in the EST+EPBD group (P=0.043; P=0.030; P=0.009; P=0.030; P=0.016; P<0.001); the residual stones, mechanical lithotripsy, stone recurrence, recurrence time and stone time shortened or reduced in the EST+EPBD group (P=0.086; P=0.035; P=0.001; P=0.739; P=0.283), success rate to remove stones increased in the EST+EPBD group (P=0.029); intraoperative time, intraoperative blood loss, length of stay, defecation days shortened or reduced in EST+EPBD group (P=0.029; P<0.001; P=0.013; P=0.002); but the cost of hospitalization in the EST+EPBD group was slightly higher (P=0.323). Conclusion EST in combination with EPBD can increase the success rate of removing stones and reduce the incidence of postoperative complications, with advantage in operation duration, time to postoperative defecation and so on. It deserved to be promoted clinically.