Efficacy of Endoscopic Isolated Papillary Small Balloon Dilation for Treating Choledocholithiasis.

OBJECTIVE

The current study aimed to compare clinical outcomes and postoperative complications of two endoscopic treatments (endoscopic isolated papillary small balloon dilation [EIPSBD] and endoscopic sphincterotomy [EST]) with endoscopic papillary balloon dilation (EPBD) in patients with choledocholithiasis.

METHODS

A total of 316 patients diagnosed with and treated for choledocholithiasis from January 2014 to December 2024 were enrolled in this nonrandomized study. The patients were divided into EIPSBD (n = 178) and EST + EPBD groups (n = 138). Postoperative morbidities, including pancreatitis, cholangitis, bleeding, and hyperamylasemia, were assessed at 3 and 24 hours. Stone clearance was also evaluated.

RESULTS

The incidence of pancreatitis was 9.55% in the EIPSBD group and 7.97% in the EST + EPBD group (P = .5). Hyperamylasemia occurred in 41.57% of the patients in the EIPSBD group and 42.03% in the EST + EPBD group (P = .9). The incidence of cholangitis, bleeding, and stone clearance was not significantly different between the two groups. The incidence of pancreatitis in female patients was greater than male patients (χ2 = 5.12, P = .025). The total complication rate was 10.67% and 10.14% in the EIPSBD and EST ± EPBD groups, respectively, and was not significantly different (P = .9).

CONCLUSION

EIPSBD and EST ± EPBD were shown to be equally effective in the treatment of choledocholithiasis with comparable postoperative complication rates. EIPSBD may be an acceptable alternative to traditional EST for stones ≤10 mm in size. Follow-up studies of longer duration will be helpful to assess long-term outcomes.