Vlavianos P, Chopra K, Mandalia S, Anderson M, Thompson J, Westaby D
Gastrointestinal Unit, Chelsea and Westminster Hospital, London, UK.
Gut. 2003 Aug;52(8):1165-9. doi: 10.1136/gut.52.8.1165.
Endoscopic balloon dilatation (EBD) of the sphincter of Oddi has been proposed as an alternative therapy with possible advantages, as compared with endoscopic sphincterotomy (ES), for removal of bile duct stones.
In a randomised study, we compared the efficacy and complication rate of the two techniques in 202 patients with common bile duct stones. Patients were followed up for 12 months.
A total of 103 patients were randomised to the EBD group and 99 to the ES group. Overall duct clearance was 87.1% and did not differ between the two groups (EBD 87.4%; ES 86.9%). The complication rate at 24 hours was 6.8% in the EBD group and 3.0% in the ES group (NS). Complications during follow up were 11.7% and 15.2% respectively (NS). A multivariate logistic regression analysis showed only the size of the largest stone to be predictive of success for either technique.
Endoscopic balloon dilatation offers no significant advantage over the well established technique of endoscopic sphincterotomy for the removal of bile duct stones.
与内镜括约肌切开术（ES）相比，内镜下Oddi括约肌球囊扩张术（EBD）已被提议作为一种具有潜在优势的替代疗法，用于胆管结石的清除。
在一项随机研究中，我们比较了202例胆总管结石患者中这两种技术的疗效和并发症发生率。对患者进行了12个月的随访。
共103例患者被随机分配至EBD组，99例被分配至ES组。总体胆管清除率为87.1%，两组之间无差异（EBD组87.4%；ES组86.9%）。EBD组24小时时的并发症发生率为6.8%，ES组为3.0%（无显著差异）。随访期间的并发症发生率分别为11.7%和15.2%（无显著差异）。多因素逻辑回归分析显示，仅最大结石的大小可预测两种技术中的任何一种的成功率。
在内镜下清除胆管结石方面，内镜球囊扩张术与成熟的内镜括约肌切开术相比没有显著优势。
