Sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis: a prospective analysis
Background and purpose: Mid-size sphincterotomy associated with large balloon dilation is an alternative to wide sphincterotomy to remove complex lithiases. However, which of the two techniques is most effective remains unclear. Hence, we conducted this study to compare both methods prospectively. M...
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| Format: | Article |
| Language: | English |
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Aran Ediciones
2015-08-01
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| Series: | Revista Espanola de Enfermedades Digestivas |
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| Online Access: | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082015000800004&lng=en&tlng=en |
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| author | Martín Alejandro Guidi Cecilia Curvale Hui Jer Hwang Julio César de María Esteban Promenzio Fernando Ragone Raúl Fernando Matanó |
| author_facet | Martín Alejandro Guidi Cecilia Curvale Hui Jer Hwang Julio César de María Esteban Promenzio Fernando Ragone Raúl Fernando Matanó |
| author_sort | Martín Alejandro Guidi |
| collection | DOAJ |
| description | Background and purpose: Mid-size sphincterotomy associated with large balloon dilation is an alternative to wide sphincterotomy to remove complex lithiases. However, which of the two techniques is most effective remains unclear. Hence, we conducted this study to compare both methods prospectively. Method: Since January 2012 until March 2014, 133 consecutive patients with complex stones were included. Group A underwent mid-size sphincterotomy associated with large balloon dilation and group B underwent wide sphincterotomy alone. Success rates were assessed for: Extraction of stones, ductal patency rate, the use of mechanical lithotripsy, dose, time and dose per radioscopy area as well as procedure-related complications. Results: Group A comprised 44 patients and group B comprised 69 patients. Overall success rate for extraction was 86.4% in group A and 70% in group B (p = 0.069). In giant lithiasis, effective extraction was 89.3% in group A and 58.6% in group B (p = 0.019). Use of mechanical lithotripsy was 15.9% and 30.4%, respectively (p = 0.142). Total radiotherapy dose was 39.8 mGy vs. 26.2 mGy, respectively (p = 0.134). Complications occurred in 6.8% and 5.5% of the procedures in each group, without significant differences among them (p = 0.856). Conclusion: Sphincterotomy plus large balloon dilation is more effective and equally safe than conventional sphincterotomy for the management of giant main bile duct lithiasis. |
| first_indexed | 2024-12-19T17:32:30Z |
| format | Article |
| id | doaj.art-735c3298a9ea47bc86e041c75fbd9a02 |
| institution | Directory Open Access Journal |
| issn | 1130-0108 |
| language | English |
| last_indexed | 2024-12-19T17:32:30Z |
| publishDate | 2015-08-01 |
| publisher | Aran Ediciones |
| record_format | Article |
| series | Revista Espanola de Enfermedades Digestivas |
| spelling | doaj.art-735c3298a9ea47bc86e041c75fbd9a022022-12-21T20:12:25ZengAran EdicionesRevista Espanola de Enfermedades Digestivas1130-01082015-08-011078483487S1130-01082015000800004Sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis: a prospective analysisMartín Alejandro Guidi0Cecilia Curvale1Hui Jer Hwang2Julio César de María3Esteban Promenzio4Fernando Ragone5Raúl Fernando Matanó6Hospital de Alta Complejidad en Red El Cruce Dr.Néstor Carlos KirchnerHospital de Alta Complejidad en Red El Cruce Dr.Néstor Carlos KirchnerHospital de Alta Complejidad en Red El Cruce Dr.Néstor Carlos KirchnerHospital de Alta Complejidad en Red El Cruce Dr.Néstor Carlos KirchnerHospital de Alta Complejidad en Red El Cruce Dr.Néstor Carlos KirchnerHospital de Alta Complejidad en Red El Cruce Dr.Néstor Carlos KirchnerHospital de Alta Complejidad en Red El Cruce Dr.Néstor Carlos KirchnerBackground and purpose: Mid-size sphincterotomy associated with large balloon dilation is an alternative to wide sphincterotomy to remove complex lithiases. However, which of the two techniques is most effective remains unclear. Hence, we conducted this study to compare both methods prospectively. Method: Since January 2012 until March 2014, 133 consecutive patients with complex stones were included. Group A underwent mid-size sphincterotomy associated with large balloon dilation and group B underwent wide sphincterotomy alone. Success rates were assessed for: Extraction of stones, ductal patency rate, the use of mechanical lithotripsy, dose, time and dose per radioscopy area as well as procedure-related complications. Results: Group A comprised 44 patients and group B comprised 69 patients. Overall success rate for extraction was 86.4% in group A and 70% in group B (p = 0.069). In giant lithiasis, effective extraction was 89.3% in group A and 58.6% in group B (p = 0.019). Use of mechanical lithotripsy was 15.9% and 30.4%, respectively (p = 0.142). Total radiotherapy dose was 39.8 mGy vs. 26.2 mGy, respectively (p = 0.134). Complications occurred in 6.8% and 5.5% of the procedures in each group, without significant differences among them (p = 0.856). Conclusion: Sphincterotomy plus large balloon dilation is more effective and equally safe than conventional sphincterotomy for the management of giant main bile duct lithiasis.http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082015000800004&lng=en&tlng=enEsfinterotomíaDilatación con balones de grandes volúmenesLitiasis compleja |
| spellingShingle | Martín Alejandro Guidi Cecilia Curvale Hui Jer Hwang Julio César de María Esteban Promenzio Fernando Ragone Raúl Fernando Matanó Sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis: a prospective analysis Revista Espanola de Enfermedades Digestivas Esfinterotomía Dilatación con balones de grandes volúmenes Litiasis compleja |
| title | Sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis: a prospective analysis |
| title_full | Sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis: a prospective analysis |
| title_fullStr | Sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis: a prospective analysis |
| title_full_unstemmed | Sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis: a prospective analysis |
| title_short | Sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis: a prospective analysis |
| title_sort | sphincterotomy plus large balloon dilation versus sphincterotomy alone for the extraction of complex lithiasis a prospective analysis |
| topic | Esfinterotomía Dilatación con balones de grandes volúmenes Litiasis compleja |
| url | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082015000800004&lng=en&tlng=en |
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