In this study, doctors from the United States compared endoscopic balloon dilation of the papilla with endoscopic biliary sphincterotomy in patients with common bile duct stones.
The team searched computerized bibliographic and scientific citations, and citations in relevant primary articles.
They identified 8 trials that compared endoscopic balloon dilation with endoscopic biliary sphincterotomy for the removal of common bile duct stones.
| There were no differences in the rates of perforation or infection.|
|American Journal of Gastroenterology|
The team found that both procedures resulted in similar outcomes with regards to overall successful stone removal and overall complications.
However, bleeding occurred less frequently with endoscopic balloon dilation (0% versus 2%).
The team found that post-procedure pancreatitis occurred more commonly in the endoscopic balloon dilation group (7% versus 4%).
The doctors did not find any differences in the rates of perforation or infection.
However, patients undergoing endoscopic balloon dilation were more likely to require mechanical lithotripsy for stone extraction (21% versus 15%).
Drs Todd Baron and Gavin Harewood concluded, "On the basis of lower rates of bleeding, endoscopic balloon dilation should be the preferred strategy…for endoscopic removal of common bile duct stones in patients with coagulopathy".
"Although endoscopic balloon dilation is theoretically attractive for use in young patients for biliary sphincter preservation, the rate of pancreatitis is higher…and cannot be routinely recommended at this time".