Korean J Gastrointest Endosc > Volume 34(3); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;34(3): 132-137.
중절개 내시경유두괄약근절개술 후 내시경유두풍선확장술을 이용한 총담관결석 제거술의 유용성
지정선·채현석·김형근·조영석·김창욱·이보인·최 황·김병욱·한석원·최규용
가톨릭대학교 의과대학 내과학교실
Usefulness of Medium Incision Endoscopic Sphincterotomy with Endoscopic Papillary Balloon Dilatation for the Removal of Common Bile Duct Stones
Jeong Seon Ji, M.D., Hiun Suk Chae, M.D., Hyung Keun Kim, M.D., Young Seok Cho, M.D., Chang Wook Kim, M.D., Bo In Lee, M.D., Hwang Choi, M.D., Byung Wook Kim, M.D., Suk Won Han, M.D. and Kyu Yong Choi, M.D.
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea

Recent meta-analysis data has shown that there was no significant difference in the rate of overall successful stone removal between endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilatation (EPBD). However, bleeding occurred more frequently in the EST group, and post-ERCP pancreatitis more commonly occurred in the EPBD group. Thus, we hypothesized that medium incision EST modestly combined with EPBD (m-EST⁢EPBD) could overcome the drawbacks of both techniques.
Fifty eight patients who underwent m-EST⁢EPBD for removal of common bile duct stones were compared with sixty patients who underwent EST only. Medium incision EST was performed with a pure cut mode and then a 12 mm diameter balloon was used for the EPBD.
Complete bile duct stone clearance was achieved in 96.7% of the patients in the EST group and in 96.5% of the patients who underwent m-EST⁢EPBD (p>0.05). There was no significant difference between the two groups for procedure-related pancreatitis. The rate for procedure- related hemorrhage was 0% in the both groups.
m-EST⁢EPBD showed the possibility of being alternative to EST for the removal of common bile duct stone. To establish effectiveness and safety of m-EST⁢EPBD, further randomized large scaled clinical studies for comparing EST and m-EST⁢EPBD are needed. (Korean J Gastrointest Endosc 2007;34:132⁣137)
Key Words: Endoscopic sphincterotomy, Endoscopic papillary balloon dilatation, Common bile duct stone
주요어: 내시경유두괄약근절개술, 내시경유두풍선확장술, 총담관결석
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