Clinical Analysis Of EST And EPBD In The Treatment Of Non-dilated Extrahepatic Bile Duct Stones

Objective:To compare the clinical efficacy and safety of endoscopic sphincterotomy(EST),endoscopic papillary balloon dilation(EPBD)and EST+EPBD in the treatment of non-dilated extrahepatic bile duct stones.Methods:A retrospective study was performed on 118 patients with non-dilated extrahepatic bile duct stones who received endoscopic treatment in our Hospital from September 2020 to January 2022.According to the therapies they received,the patients were divided into EST group(n=45),EPBD group(n=35)and EST+EPBD group(n=38).The incidence of postoperative complications,perioperative related indexes,and serological indexes before and 7 days after operation were compared among 3 groups.Results:The incidence of hyperamylasemia and Post-ERCP pancreatitis in EPBD group was higher than that in EST group(40.0% VS 15.6%,42.9% VS 13.3%),P<0.05.The incidence of hyperamylasemia and Post-ERCP pancreatitis in EPBD group was higher than that in EST+EPBD group(40.0% VS 10.5%,42.9% VS 13.2%),P<0.05;The incidence of postoperative perforation,bleeding and infection of biliary tract in 3 groups was compared,P>0.05;The incidence of biliary retrograde infection and stone recurrence in EST+EPBD group was lower than that in EST group(5.3% VS 26.7%,2.6% VS 20.0%),P<0.05;The successful rate of primary stone removal in EST+EPBD group was higher than that in EST group(97.4% VS 77.8%),P<0.05;The mechanical gravel rate in EST+EPBD group was lower than that in EST group(5.3% VS 26.7%),P<0.05;The operative time of EPBD group was shorter than that of EST group,P<0.05;The operative time of EST+EPBD group was shorter than that of EST group and EPBD group,P<0.05;Comparison of residual stone rate and hospitalization stays among 3groups,P>0.05;Serological indexes of the three groups at 7 days after operation were compared with those before operation,P<0.05;Before operation,the serological indexes of the three groups were compared,P>0.05;At 7 days after operation,the serological indexes of the three groups were compared,P>0.05.Conclusion:EST+EPBD is safe and feasible in the treatment of non-dilated extrahepatic bile duct stones,with low incidence of short-term and long-term complications and no aggravation of inflammatory stress response.