Endoscopic Papillary Dilation vs. Endoscopic Sphincterotomy in Endoscopic Removal of Bile Duct Stones.

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  • 総胆管結石治療における内視鏡的乳頭拡張術と内視鏡的乳頭括約筋切開術の比較検討

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Abstract

Endoscopic Papillary Dilation (EPD) and Endoscopic sphincterotomy (EST) were attempted in 30 patients with bile duct stones All of the stones were less than 1.2 cm in diameter. Extraction of stones was performed successfully in both groups. No serious intraoperative complications were observed. Laboratory tests before and after treatments included white blood cell (WBC) counts, serum C-reactive protein (CRP) levels, serum amylase, and serum total bilirubin. No significant difference in blood chemistry analysis were found between EPD and EST before or after treatment, except for serum total bilirubin levels which elevated in EST patients (p < 0.001) . Complications of mild pancreatitis were observed in three patients (10%) in EPD group and two patients (7%) in EST group. In one day of conservative management, they showed complete recovery. No patient experienced post-treatment bleeding. We conclude that therapeutic effectiveness of removal of bile duct stones is almost same between EST and EPD.

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