Comparison of 12- and 15-mm endoscopic papillary large balloon dilation combined with a limited endoscopic sphincterotomy for large bile duct stones: A propensity score-matched analysis

IF 1.1 4区医学 Q4 GASTROENTEROLOGY & HEPATOLOGY

Arab Journal of Gastroenterology Pub Date : 2025-05-06 DOI:10.1016/j.ajg.2025.03.003

Qian Zhang , Lili Chen , Jun Liu , Weiwei Chen , Meng Zhou , Chaowu Chen

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引用次数: 0

Abstract

Background and study aims

Endoscopic papillary large balloon dilation (EPLBD) combined with endoscopic sphincterotomy (EST) has been increasingly used to remove large common bile duct (CBD) stones. However, the clinical outcomes of stone extraction have rarely been investigated in regard to the size of the balloon. The aim of this study was to assess the short- and long-term outcomes of 12- and 15-mm EPLBD with a limited EST for large CBD stones.

Patients and methods

Patients without prior endoscopic retrograde cholangiopancreatography (ERCP) who received 12- or 15-mm EPLBD in combination with a limited EST for large CBD stones at our center between January 2013 and December 2020 were recruited. Matched pairs with 12- and 15-mm EPLBD were generated.

Results

A total of 161 patients were included, with 50 patients successfully matched in each group. The total procedure time (36.8 min vs. 47.3 min, p = 0.003) and the tone removal time (30.5 min vs. 39.2 min, p = 0.008) were significantly lower in the matched 15-mm EPLBD group, while the initial and overall stone removal success rates were comparable between the two groups (p > 0.05). The matched 15-mm EPLBD group had a lower incidence of post-ERCP pancreatitis (PEP) compared to the matched 12-mm EPLBD group (2.0 % vs. 16.0 %, p = 0.031). The cumulative long-term biliary complications were not statistically different between the two groups (log-rank test p = 0.612).

Conclusion

15-mm EPLBD combined with a limited EST shortened the procedure time and reduced the incidence of PEP without increasing long-term biliary complications compared to 12-mm EPLBD combined with a limited EST.

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12和15毫米内镜下乳头状大球囊扩张联合有限内镜下括约肌切开术治疗大胆管结石的比较：倾向评分匹配分析。

背景与研究目的：内镜下乳头状大球囊扩张术（EPLBD）联合内镜下括约肌切开术（EST）越来越多地用于大胆总管（CBD）结石的切除。然而，结石取出的临床结果很少与球囊的大小有关。本研究的目的是评估12毫米和15毫米EPLBD与有限EST对大型CBD结石的短期和长期结果。患者和方法：招募了2013年1月至2020年12月期间在本中心接受12或15毫米EPLBD联合有限EST治疗大CBD结石的未经内镜逆行胆管造影（ERCP）的患者。生成了具有12和15 mm EPLBD的配对对。结果：共纳入161例患者，每组成功配对50例。15毫米EPLBD组的总手术时间（36.8分钟vs. 47.3分钟，p = 0.003）和拔牙时间（30.5分钟vs. 39.2分钟，p = 0.008）显著低于匹配的15毫米EPLBD组，而两组之间的初始和总体拔牙成功率相当（p = 0.05）。与匹配的12 mm EPLBD组相比，匹配的15 mm EPLBD组ercp后胰腺炎（PEP）的发生率较低（2.0%比16.0%,p = 0.031）。两组患者累积的长期胆道并发症无统计学差异（log-rank检验p = 0.612）。结论：与12mm EPLBD联合有限EST相比，15mm EPLBD联合有限EST缩短了手术时间，降低了PEP的发生率，且未增加长期胆道并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arab Journal of Gastroenterology Medicine-Gastroenterology

CiteScore

2.70

自引率

0.00%

发文量

期刊介绍： Arab Journal of Gastroenterology (AJG) publishes different studies related to the digestive system. It aims to be the foremost scientific peer reviewed journal encompassing diverse studies related to the digestive system and its disorders, and serving the Pan-Arab and wider community working on gastrointestinal disorders.