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Evidence summaries

Endoscopic Balloon Sphincter Dilation (Sphincteroplasty) Versus Sphincterotomy for Common Bile Duct Stones

Endoscopic balloon dilation is slightly less successful than endoscopic sphincterotomy in stone extraction and more risky regarding pancreatitis, but it is associated with a lower rate of bleeding. Level of evidence: "A"

A Cochrane review 1 (abstract , review [Abstract]) included 15 studies with a total of 1768 subjects. Endoscopic balloon dilation was slightly less successful for stone removal (relative risk (RR) 0.90, 95% confidence interval (CI) 0.84 to 0.97), required higher rates of mechanical lithotripsy (RR 1.34, 95% CI 1.08 to 1.66), and carried a higher risk of pancreatitis (RR 1.98, 95 CI 1.35 to 2.90). Conversely, endoscopic balloon dilation has statistically significant lower rates of bleeding. Endoscopic balloon dilation leads to significantly less short-term infection and long-term infection.

References

  • Weinberg BM, Shindy W, Lo S. Endoscopic balloon sphincter dilation (sphincteroplasty) versus sphincterotomy for common bile duct stones. Cochrane Database Syst Rev 2006 Oct 18;(4):CD004890. [PubMed]

Primary/Secondary Keywords