Clinical analysis of SES combined with EPBD in the treatment of choledocholithiasis with a diameter greater than 1 cm

ObjectiveTo investigate the clinical value of small endoscopic sphincterectomy(SES) combined with endoscopic papillary balloon dilation(EPBD) in the treatment of choledocholithiasis with a diameter greater than 1 cm.

MethodsFrom 2011 to 2018, the cholangiolithiasis patients treated with ERCP were randomly divided into the SES combined with EPBD group, EST large incision group and EPBD group according to the treatment method(30 cases each group).The incidence rates of pancreatitis and upper gastrointestinal hemorrhage within 1 week after surgery, recurrence rate of choledocholithiasis after 12 months of surgery, operation time and intraoperative stone crusher usage in three groups were analyzed.

ResultsThe stone extraction in all cases were successful.The intraoperative and postoperative digestive tract perforation and cholangitis were not found in three groups.The incidence rates of upper gastrointestinal bleeding in SES combined with EPBD group, EPBD group and EST group after 1 week of surgery gradually increased in turn(P < 0.05), 1 case with upper gastrointestinal bleeding in EST group was improved after treated with transfusion.The incidence rate of postoperative 1 week pancreatitis in the SES combined with EPBD group and EST group were 3.3%, and which was lower than that in EPBD group(20%)(P < 0.05).The recurrence rates of choledocholithiasis in SES combined with EPBD group, EPBD group and EST group after 12 months of operation gradually increased in turn(P < 0.05).The operation time in SES combined with EPBD group, EST group and EPBD group gradually increased in turn(P < 0.05).The intraoperative stone crusher usage in SES combined with EPBD group, EPBD group and EST group gradually increased in turn(P < 0.05).

ConclusionsThe SES combined with EPBD in the treatment of choledocholithiasis with a diameter greater than 1cm is short time, stone crusher usage, and incidence rates of postoperative pancreatitis and upper gastrointestinal hemorrhage.The recurrence rate of choledocholithiasis of long-term complications can be reduced.