Outcomes of endoscopic papillary large balloon dilatation combined with sphincterotomy for removing large common bile duct stones and risk factors for stone recurrence

Abstract

Abstract Background To evaluate the outcomes of endoscopic sphincterotomy (EST) combined with endoscopic papillary large balloon dilation (EPLBD) for removing stones from large common bile duct (CBD) and identify the risk factors for stone recurrence. Methods After reviewing 69 patients with large CBD stones, 44 were included in the group treated with EST combined with EPLBD (ESLBD) and 25 patients were in included in the EPLBD group. The clinical data of both groups, including success rates of removing large CBD stones, complications, hospital stay and total costs of hospitalization were compared. In addition, the risk factors for stone recurrence were explored. Results The ESLBD and EPLBD groups showed similar success rates of stone clearance (97.27% vs 96.00%). However, the use of lithotripsy and the incidence of post-endoscopy pancreatitis (PEP) were higher in the EPLBD group. The recovery time and total costs of hospitalization were also lower in the ESLBD group. No serious complications were identified in our study, such as hemorrhage, perforation and death; and no significant differences in infection, procedural time, hospital stay and procedural costs of groups. Multiple logistic regression analysis showed that lithotripsy and maximum transverse diameter of the CBD stone were independent risk factors for stone recurrence. Conclusions ESLBD was superior to EPLBD alone for removing large CBD stones. In addition, the maximum transverse diameter of CBD stone and lithotripsy were independent risk factors for associated with stone recurrence.