부산대학교 도서관

Background : Endoscopic papillary balloon dilation (EPBD) is associated with a lower risk of hemorrhage and is easier to perform but is associated with higher incidence of pancreatitis than endoscopic sphincterotomy (EST). It is reported that 5-minute EPBD improves the efficacy of stone extraction and reduces the risk of pancreatitis compared with the conventional 1-minute EPBD. Therefore, we conducted a retrospective comparative study of 5-minute EPBD vs. EST with respect to stone extraction and pancreatitis. Methods : All enrolled cases had bile duct stones of less than 10mm. The consecutive 49 cases treated by 5-minute EPBD from October 2013 to October 2014 were compared with the consecutive 82 cases treated by EST from May 2010 to October 2013. The diameter of the EPBD balloon in this trial was 10mm in all cases. Results : Mean age was 75.7 yr in the EPBD group and 69.7 yr in the EST group, showing a significant difference. Gender, stone diameter and number of stones did not significantly differ between the two groups. The rate of complete extraction of bile duct stones in the first session was 100% in both groups. Procedure time was approximately 30 minutes in both groups and did not show a significant difference. Pancreatitis was seen in 2.0% of the EPBD group and 6.1% of the EST group, and bleeding occurred only in the EST group (2.4%) although the rates of pancreatitis and bleeding did not show significant differences. Conclusion : 5-minute EPBD was associated with high performance of stone extraction and low incidence of pancreatitis. It may be the first choice as a method for extracting bile duct stones of less than 10 mm because we can expect better long-term outcomes with EPBD than with EST. However, a randomized trial is needed to reveal long-term outcomes.