ObjectiveTo explore the efficacy and safety of simple endoscopic papillary balloon dilation in ERCP treatment of choledocholithiasis with periampullary duodenal diverticula (PAD).
MethodsThe clinical data and therapeutic process of 301 patients undergoing endoscopic retrograde cholangiolithotomy were retrospectively analyzed.The patients were divided into PAD group and non-PAD group, and the differences of baseline characteristics and therapeutic indicators between the two groups were compared.The PAD group was further divided into the simple balloon dilation group and sphincterotomy combined with balloon dilation group, and the stone removal effect and postoperative complications of the two groups were compared.
ResultsThe overall incidence of PAD in 301 patients with choledocholithiasis was 51.2%.There were statistically significant differences between the PAD group and non-PAD group in gender, age, diameter of the common bile duct, maximum diameter of stones, and opening method of the ampullary sphincter (P < 0.05 to P < 0.01).The implementation rate of simple balloon dilation in the PAD group was significantly higher than that in the non-PAD group (P < 0.01).There were statistically significant differences in the methods of expanding the ampullary sphincter in patients with different diverticulum types.The rate of prophylactic hemostasis using metal clips in the EPBD group was significantly lower than that in the EST+EPBD group, and the diameter of the common bile duct was larger than that in the EST+EPBD group (P < 0.05 to P < 0.01).
ConclusionsSimple endoscopic papillary balloon dilation is safe and effective in ERCP with PAD, and demonstrates the advantage of simplified operation.
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