Abstract:
BACKGROUND:Endoscopic sphincterotomy (ES) is widely performed in patients with common bile duct stones (CBDS). However, the long-term outcomes of patients following ES have not been sufficiently elucidated. Impaired papillary function following ES may result in additional late complications. In contrast, endoscopic papillary balloon dilation (EPBD)-another option for treating CBDS-is expected to preserve papillary function. This study aimed to compare the long-term outcomes of patients with CBDS treated with ES to those treated with EPBD in a large cohort. In addition, a subgroup analysis was performed, according to gallbladder (GB) status. METHODS:A cohort study was performed using propensity score matching to reduce treatment selection bias. This involved the analysis of follow-up data for 1086 patients who underwent EPBD or ES for CBDS. RESULTS:Propensity score matching extracted 246 pairs of patients. The median (interquartile range) follow-up period after EPBD or ES was 93.5 (46.8-129.2) months and 90 (42-139.3) months, respectively. The incidence of CBDS recurrence after EPBD and ES were 8.5 and 15.0 %, respectively. The hazard ratio (95 % CI) was 0.577 (0.338-0.986) (P = 0.044). Based on the status of the GB, the incidence of CBDS recurrence was significantly different between post-EPBD and post-ES in the group with cholecystectomy after EPBD/ES (P = 0.013). CONCLUSIONS:The incidence of biliary complications was significantly lower in patients after EPBD than in those after ES, and this outcome appeared most markedly in patients who also underwent cholecystectomy.
journal_name
J Gastroenteroljournal_title
Journal of gastroenterologyauthors
Doi S,Yasuda I,Mukai T,Iwashita T,Uemura S,Yamauchi T,Nakashima M,Adachi S,Shimizu M,Tomita E,Itoi T,Moriwaki Hdoi
10.1007/s00535-012-0707-8subject
Has Abstractpub_date
2013-09-01 00:00:00pages
1090-6issue
9eissn
0944-1174issn
1435-5922journal_volume
48pub_type
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