| Objective: To study the safety and efficacy of small endoscopic sphincterotomy combine with endoscopic papillary balloon dilation for patients with choledocholithiasis.Methods: From Jan.2012 to Jan.2016,146 patients diagnosed as choledocholithiasis had received EST or SEST+EPBD in the People’s Hospital of Chizhou and the related data were retrospectively analyzed,the treatment outcomes(gravel incidence rate、complete stone clearance rate、one-time stone clearance rate)and complication rate(hemorrhage、intestinal perforation、hyperamylasemia 、acute pancreatitis、cholangitis)were compared between two groups.Results: The complete stone clearance rate in SEST+EPBD group was 97.01%(65/67),which was higher than that in EST group(96.20%,76/79),there was no statistically significant(P=1>0.05);The one-time stone clearance rate in SEST+EPBD group was 94.02%(63/67),which was higher than that in EST group(91.13%,72/79),there was no statistically significant(P=0.51>0.05);The gravel incidence rate in SEST+EPBD group was 7.46%(5/67),which was lower than that in EST group(15.15%,12/79),there was no statistically significant(P=0.147>0.05);The total complication rate in SEST+EPBD group was 20.89%(14/67),which was lower than that in EST group(39.24%,31/79),the difference was significant(P=0.017<0.05);The incidence of intestinal perforation、hyperamylasemia 、acute pancreatitis、cholangitis in SEST+EPBD group were similar with EST group,there was no statistically significant;The hemorrhage rate in SEST+EPBD group(1.49%,1/67)was significant lower than that of EST group(10.13%,8/79)(P=0.0312<0.05);The recurrence rate in SEST+EPBD group(1.49%,1/67)was significant lower than that of ESTgroup(10.13%,8/79)(P=0.0312<0.05).Conclusion: SEST combine with EPBD is safe and effective for patients with choledocholithiasis,and could also significantly reduce the incidence of bleeding,reduce the recurrence rate of choledocholithiasis. |
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