| Combined endoscopic sphincterotomy and large balloon sphincteroplasty for bile duct stones |
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Min Kyung Kim, Myung-Hwan Kim, Tae Yoon Lee, Hyoung-Chul Oh, Seung Hyun Kwon, Jeung Hye Han, Hyung Oh Choi, Soo Jung Park, Tae Hyup Kim, Sang Soo Lee, Dong Wan Seo, Sung Koo Lee, Ta |
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한양대학교 의과대학 호흡기내과 |
| 원저 : 내시경 유두괄약근 절개술과 큰 풍선 유두 확장술을 병행한 담관결석의 치료 |
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김민경&#;김명환&#;이태윤&#;오형철&#;권승현&#;한정혜 최형오&#;박수정&#;김태협&, Myung-Hwan Kim, Tae Yoon Lee, Hyoung-Chul Oh, Seung Hyun Kwon, Jeung Hye Han, Hyung Oh Choi, Soo Jung Park, Tae Hyup Kim, Sang Soo Lee, Dong Wan Seo, Sung Koo Lee, Ta |
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| Abstract |
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Background : The combined use of small endoscopic sphincterotomy (EST) followed by endoscopic papillary large
balloon dilation (EPLBD) might be associated with a lower incidence of procedure-related complications such as
pancreatitis, bleeding or perforation, compared to the use of EPLBD or a large EST alone. The aim of this retrospective
study was to evaluate the utility of a combined EST and EPLBD method for the removal of common bile duct (CBD)
stones that could not be extracted by use of an EST and conventional techniques.
Methods : Between March 2005 and September 2006, a total of 35 patients with CBD stones were enrolled. Fourteen
patients had received a previous EST, and 21 patients underwent an EST. The sphincterotomy site was then dilated with
a 12～18 mm diameter balloon.
Results : The average number of stones was 3.6±2.9 (range: 110). The average maximum stone diameter was 26.11
±8.88 mm (range: 12～50 mm). Complete stone removal was accomplished in 31 patients (88.6%). In 9 patients (25.7%),
a mechanical lithotripsy was required. No episode of true pancreatitis occurred. A procedure-related perforation occurred
in one patient (2.8%) and the patient was treated with NPO and antibiotics. No procedure-related bleeding or mortality
was observed. The procedure was performed safely in 9 patients (25.7%) with a periampullary diverticulum and in 14
patients (40.0%) with a previous EST.
Conclusions : Combined EST and EPLBD may be a safe and effective method, and may be a good alternative
treatment for removing CBD stones that cannot be extracted by an EST and conventional techniques. However,
prospective studies based on a large number of patients are needed.(Korean J Med 73:474-480, 2007) |
| Key Words:
Endoscopic sphincterotomy, Endoscopic papillary large balloon dilation, Common bile duct stone |
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