Endoscopy 2022; 54(S 01): S210-S211
DOI: 10.1055/s-0042-1745148
Abstracts | ESGE Days 2022
ESGE Days 2022 Digital poster exhibition

EFFICACY OF ENDOSCOPIC PAPILLARY BALLOON DILATION AFTER SPHINCTEROTOMY FOR DIFFICULT BILE DUCT STONE CLEARANCE: A CASE-CONTROLLED STUDY

K. Amalou
1   Algiers, Gastroenterology, Algiers, Algeria
,
F. Belghanem
1   Algiers, Gastroenterology, Algiers, Algeria
,
M.T. Medkour
1   Algiers, Gastroenterology, Algiers, Algeria
,
R. Rekab
1   Algiers, Gastroenterology, Algiers, Algeria
,
N. Benboudiaf
1   Algiers, Gastroenterology, Algiers, Algeria
,
M. Benachour
1   Algiers, Gastroenterology, Algiers, Algeria
,
S. Kordjani
1   Algiers, Gastroenterology, Algiers, Algeria
,
D. Kezoula
1   Algiers, Gastroenterology, Algiers, Algeria
› Author Affiliations
 

Aims To evaluate the efficacy and safety of endoscopic sphincterotomy (EST)+endoscopic papillary large balloon dilation (EPLBD-s) vs isolated EST (iEST) for difficult bile duct stone clearance.

Methods In this prospective case-controlled single center study, all patients with naïve papilla undergoing ERCP to treat a single or multiple large stone (≥15 mm). Patients in Group A underwent EPLBD-s. Patients in Group B (control group) underwent iEST. Outcomes were compared regarding efficacy (complete clearance, number of sessions, biliary stenting) and safety (frequency, type and grade of complications).

Results There were included 127 patients, 58 (45.6%) in Group A and 69 (54.3%) in Group B. The mean diameter of the stones was similar in the two groups (17.8±3.4 and 16.9±4.3). Patients had multiple BDS, EPLBD-s=39/58, 67.2% vs. iEST=34/69, 49.2%, p=0.02. Patients in Group A achieved a higher clearance rate (51/58, 87.9%) than iEST (43/69, 62.3%), p<0,001; and was attained within the first therapeutic session in EPLBD-s=74.1% vs. iEST=43.4%, p<0.001. Patients in Group A underwent fewer therapeutic sessions (1.3±0.2 vs 2.1±1.2, P<0.001), and fewer required mechanical (12.9% vs 42.4%, p=0.003) or biliary stenting (21.6% vs 72.3%, p<0.001). There was no difference in complication rate, EPLBD-s=11.2% vs. iEST=12.3%, p=0.82.

Conclusions EST+EPLBD is a safe and superior over only stent for treatment of difficult BDS, leading to high rates of complete stone clearance and reducing the need for lithotripsy and biliary stenting.



Publication History

Article published online:
14 April 2022

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