Long-term outcomes after endoscopic sphincterotomy versus endoscopic papillary balloon dilation for bile duct stones

Rate of duodenal-biliary reflux increases in patients with recurrent common bile duct stones: evidence from barium meal examination

“…2 Stone re-formation because of chronic inflammation of the biliary duct is generally considered the other important cause of CBDS recurrence, which is associated with bile stasis and duodenal-biliary reflux (DBR). [3][4][5][6][7][8][9] Stone recurrence occurs more frequently in patients who undergo endoscopic sphincterotomy (EST ) than endoscopic papillary balloon dilation (5.7%-26.7% vs 1.6%-8.1%). [3][4][5][6] More DBR may be the cause of the higher recurrence rate in patients undergoing EST.…”

“…[3][4][5][6][7][8][9] Stone recurrence occurs more frequently in patients who undergo endoscopic sphincterotomy (EST ) than endoscopic papillary balloon dilation (5.7%-26.7% vs 1.6%-8.1%). [3][4][5][6] More DBR may be the cause of the higher recurrence rate in patients undergoing EST. 2 Sphincter of Oddi damage after EST could lead to potential biliary infection and stone recurrence secondary to reflux of duodenal contents into the bile duct.…”

Large bile duct stones

“…Long-term complications of EBD versus ES have also been specifically assessed in two trials, including 314 patients. Compared to EBD, ES is a risk factor for stone recurrence and biliary sphincter dysfunction in studies with follow-up periods of up to 7 years [18,19].…”

Management of suspected stones in the common bile duct

“…36 This high complication rate 37 has not been duplicated in Asian trials. 38 More recently, endoscopic papillary balloon dilatation following a small sphincterotomy has been reported 39 and is rapidly becoming the approach of choice for removing large stones (> 12-15 mm).…”