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[Various endoscopic transpapilary interventions for choledocholithiasis].

V B Rinchinov1, A N Plekhanov2, E Yu Ludupova1

  • 1Semashko Republic Clinical Hospital, Ministry of Health of Republic of Buryatia, Ulan-Ude, Russia.

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Summary

Endoscopic partial papillosphincterotomy with balloon dilatation is the safest endoscopic treatment for common bile duct stones, showing fewer complications than other methods. This approach minimizes risks during and after the procedure for choledocholithiasis patients.

Keywords:
balloon dilatationcholedocholithiasismechanical lithotripsypapillosphincterotomy

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Biliary Interventions

Background:

  • Choledocholithiasis, or common bile duct stones, is a common condition requiring intervention.
  • Various endoscopic transpapillary interventions exist for stone removal.
  • Evaluating the comparative efficacy and safety of these methods is crucial.

Purpose of the Study:

  • To compare the efficacy and safety of three common endoscopic transpapillary interventions for choledocholithiasis.
  • To determine the optimal endoscopic approach for managing common bile duct stones.

Main Methods:

  • A randomized controlled trial involving 90 patients with choledocholithiasis.
  • Patients were allocated to three groups: Group A (endoscopic partial papillosphincterotomy with balloon dilatation), Group 1 (endoscopic papillosphincterotomy), and Group 2 (endoscopic papillosphincterotomy with mechanical lithotripsy).

Main Results:

  • The main group (partial papillosphincterotomy with balloon dilatation) exhibited the lowest complication rate (6%).
  • Complication rates were significantly higher in the comparison groups: 19% in Group 1 and 38% in Group 2.
  • Specific complications like acute pancreatitis and cholangitis were less frequent in the main group.

Conclusions:

  • Endoscopic partial papillosphincterotomy combined with balloon dilatation is recommended for choledocholithiasis.
  • This method offers a minimal risk of intra- and postoperative complications compared to other endoscopic interventions.