Can endoscopic papillary balloon dilation really preserve sphincter of Oddi function?

摘要: BACKGROUND—Endoscopic papillary balloon dilation (EPBD) is assumed to preserve sphincter of Oddi function because it causes little trauma the papilla. However, few studies have addressed this issue specifically. In study, we investigated whether EPBD can function, and evaluated or not such preservation has clinical significance. METHODS—Seventy patients with common bile duct (CBD) stones were randomly assigned endoscopic sphincterotomy (EST). Sphincter (SO) was measured by manometry before, one week after, year after treatment. Incidence pneumobilia later complications compared between two groups at year. Series manometric data within each group groups. For a more detailed analysis cumulative incidence complications, retrospective cohorts added study groups, giving total number 235 patients in 126 in EST group. RESULTS—Baseline characteristics did differ significantly 35 EPBD 35 EST patients. CBD discharged successfully all cases. pressure, SO basal peak pressures, contraction frequency decreased both The damage severe group, completely disappeared 23 patients group. lower than (p<0.01) whereas recurred cholecystitis appeared similar rate A complete series up obtained 55 patients; 28 in post-EPBD 27 in post-EST pressures recovered but these measures still remained those before (p< 0.01). recover even Kaplan-Meier 235 EPBD 126 EST for median follow 37 months revealed incidences biliary as recurrent cholangitis, (p<0.05). risk also (p<0.01). CONCLUSIONS—Preservation somewhat reduced. successful EST. Such may be clinically beneficial prevention complications. Keywords: dilation; manometry; Oddi; stone