Jornal de Hepatologia e Distúrbios Gastrointestinais
Acesso livre

Abstrato

Estudo prospetivo randomizado controlado de dilatação por balão grande versus litotripsia mecânica para cálculos biliares grandes

Netinatsunton N, Attasaranya S, Pornpininworak K, Sottisuporn J, Witeerungrot T, Ovartlarnporn B, Suntharapornchai P, Jongbunyanuparp T and Geater A

Background: There were limited data of large balloon dilation (LBD) versus mechanical lithotripsy (ML) in large bile duct stone removal.

Aims: To compare the efficacy of sphincterotomy (EST) with LBD or ML in removal of stone with a transverse diameter ≥ 15 mm. Methods: 85 were prospectively randomized to EST-LBD (n=44) or EST- ML (n=41).

Results: The stone sizes were comparable (25.96+9.80 in EST-LBD vs. 24.75+8.30 mm in EST-ML, p=0.536). The initial stone clearance (ISC) rate was similar in both groups. The overall stone clearance (OSC) rate after ML rescue was 84.1% in ESTLBD and after LBD rescue was 80.5% in EST-ML (p=0.663). Stone >25 mm had lower ISC rate (50% versus 76.5% for stone 25 mm (84% vs. 42%, p=0.003). The mean procedure time was shorter in EST-LBD than EST-ML (13.26 vs. 19.39 minutes, p=0.036). The complication rates were comparable between EST-ML and EST-LBD (26.8% vs. 20.4%, p=0.489).

Conclusions: EST-LBD is as effective and safe as EST-ML for large stone removal with less time-consuming.