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Effects Comparison between Endoscopic Papillary Large Balloon Dilatation and Endoscopic Sphincterotomy for Common Bile Duct Stone Removal.

Guo Y, Li C, Lei S, Zhi F - Gastroenterol Res Pract (2015)

Bottom Line: Endoscopic sphincterotomy (EST) is a treatment of choice for stone extraction and is now most frequently used.The study was to compare the efficacy of endoscopic papillary large balloon dilatation (EPLBD) and endoscopic sphincterotomy (EST) for common bile duct stone removal.EPLBD showed better efficacy in certain conditions compared to EST, however with shortcomings, such as more duration, higher mechanical lithotripsy using rate, more serious overall complications rate, and bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Guangdong Provincial Key Laboratory of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

ABSTRACT
Endoscopic sphincterotomy (EST) is a treatment of choice for stone extraction and is now most frequently used. The study was to compare the efficacy of endoscopic papillary large balloon dilatation (EPLBD) and endoscopic sphincterotomy (EST) for common bile duct stone removal. Trials comparing the effects between EPLBD and EST treatment were searched according to the study protocol. Overall stone removal rate, complete removal rate in 1st session, treatment duration, mechanical lithotripsy using rate, and overall complication rate were compared using risk ratio (RR) and mean difference (MD) and their 95% confidence interval (CI) via RevMan 5.2 software. For overall stone removal rate, two therapies showed similar effect, but EPLBD showed better overall stone removal rate for stone >10 mm in diameter. For complete stone removal rate in 1st session, no difference was found, even for those with stone >10 mm in diameter; EPLBD showed longer treatment duration, higher mechanical lithotripsy using rate obvious overall complications rate, and more serious bleeding, whereas there were no significant differences for perforation, hyperamylasemia, pancreatitis, and cholecystitis/cholangitis. EPLBD showed better efficacy in certain conditions compared to EST, however with shortcomings, such as more duration, higher mechanical lithotripsy using rate, more serious overall complications rate, and bleeding.

No MeSH data available.


Related in: MedlinePlus

Comparison of treatment duration (a) and mechanical lithotripsy (b) using rate of EPLBD and EST treatment.
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Related In: Results  -  Collection


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fig3: Comparison of treatment duration (a) and mechanical lithotripsy (b) using rate of EPLBD and EST treatment.

Mentions: There was significant heterogeneity in the assessment of treatment duration (P < 0.00001, I2 = 90%), so random effect model was used. It turned out that the two kinds of treatment were significantly different (MD = −5.05, 95% CI: −9.55~−0.54, P = 0.03; Figure 3(a)), and EPLBD showed longer treatment duration. Fixed effect model was used for mechanical lithotripsy assessment for no heterogeneity (P = 0.13, I2 = 37%), and the RR value was 0.47 with 95% CI being between 0.37 and 0.60 (P < 0.00001; Figure 3(b)). EPLBD treatment had higher mechanical lithotripsy using rate compared with EST treatment.


Effects Comparison between Endoscopic Papillary Large Balloon Dilatation and Endoscopic Sphincterotomy for Common Bile Duct Stone Removal.

Guo Y, Li C, Lei S, Zhi F - Gastroenterol Res Pract (2015)

Comparison of treatment duration (a) and mechanical lithotripsy (b) using rate of EPLBD and EST treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4553337&req=5

fig3: Comparison of treatment duration (a) and mechanical lithotripsy (b) using rate of EPLBD and EST treatment.
Mentions: There was significant heterogeneity in the assessment of treatment duration (P < 0.00001, I2 = 90%), so random effect model was used. It turned out that the two kinds of treatment were significantly different (MD = −5.05, 95% CI: −9.55~−0.54, P = 0.03; Figure 3(a)), and EPLBD showed longer treatment duration. Fixed effect model was used for mechanical lithotripsy assessment for no heterogeneity (P = 0.13, I2 = 37%), and the RR value was 0.47 with 95% CI being between 0.37 and 0.60 (P < 0.00001; Figure 3(b)). EPLBD treatment had higher mechanical lithotripsy using rate compared with EST treatment.

Bottom Line: Endoscopic sphincterotomy (EST) is a treatment of choice for stone extraction and is now most frequently used.The study was to compare the efficacy of endoscopic papillary large balloon dilatation (EPLBD) and endoscopic sphincterotomy (EST) for common bile duct stone removal.EPLBD showed better efficacy in certain conditions compared to EST, however with shortcomings, such as more duration, higher mechanical lithotripsy using rate, more serious overall complications rate, and bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Guangdong Provincial Key Laboratory of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

ABSTRACT
Endoscopic sphincterotomy (EST) is a treatment of choice for stone extraction and is now most frequently used. The study was to compare the efficacy of endoscopic papillary large balloon dilatation (EPLBD) and endoscopic sphincterotomy (EST) for common bile duct stone removal. Trials comparing the effects between EPLBD and EST treatment were searched according to the study protocol. Overall stone removal rate, complete removal rate in 1st session, treatment duration, mechanical lithotripsy using rate, and overall complication rate were compared using risk ratio (RR) and mean difference (MD) and their 95% confidence interval (CI) via RevMan 5.2 software. For overall stone removal rate, two therapies showed similar effect, but EPLBD showed better overall stone removal rate for stone >10 mm in diameter. For complete stone removal rate in 1st session, no difference was found, even for those with stone >10 mm in diameter; EPLBD showed longer treatment duration, higher mechanical lithotripsy using rate obvious overall complications rate, and more serious bleeding, whereas there were no significant differences for perforation, hyperamylasemia, pancreatitis, and cholecystitis/cholangitis. EPLBD showed better efficacy in certain conditions compared to EST, however with shortcomings, such as more duration, higher mechanical lithotripsy using rate, more serious overall complications rate, and bleeding.

No MeSH data available.


Related in: MedlinePlus