Endoscopic Sphincterotomy Plus Balloon Dilation Versus Sphincterotomy Alone, Endoscopic Management of Common Bile Duct Stones: A Propensity Score Matching-Based Cohort Analysis.

BACKGROUND

Endoscopic sphincterotomy plus balloon dilation (ESBD), which combines a small endoscopic sphincterotomy (EST) with endoscopic papillary balloon dilation (EPBD), has recently gained attention.

AIMS: This study aimed to compare the clinical outcomes of ESBD and EST in the management of common bile duct stones (CBDSs).

METHODS

We conducted a retrospective evaluation of 1067 patients who underwent ESBD or EST for the treatment of CBDSs (≤ 12 mm) between January 2017 and December 2024. The patients were divided into two groups on the basis of endoscopic management, and propensity-score matching generated 224 patient pairs to balance the group characteristics.

RESULTS

The technical success rate was significantly higher in the ESBD group (96.8% vs. 91.0%, p = 0.015). Furthermore, the total number of endoscopic retrograde cholangiopancreatography sessions required for complete stone extraction was significantly lower in the ESBD group. Early adverse event (AE) and the incidence of bleeding were significantly lower in the ESBD group (2.6% vs. 9.8%, p = 0.002). The cumulative late AE were 10.7% and 14.2% in the ESBD and EST groups, respectively.

CONCLUSION

ESBD for the management of CBDSs was more effective than EST, and no differences in long-term outcomes were observed during a relatively long follow-up period.