Abstract
AIM
To evaluate the efficacy of the most common endoscopic transpapillary interventions for choledocholithiasis in randomized controlled trial.
MATERIAL AND METHODS
There were 90 patients with choledocholithiasis who were randomized into 3 groups: main, clinical comparison 1, clinical comparison 2. In the main group A (n=30), patients underwent endoscopic partial papillosphincterotomy combined with balloon dilatation, in the group of clinical comparison 1 (n=30) - endoscopic papillosphincterotomy, in the group of clinical comparison 2 (n=30) - endoscopic papillosphincterotomy with mechanical lithotripsy.
RESULTS
The greatest number of complications (38%) was observed in the group of clinical comparison 2. Less morbidity was noted in the group of clinical comparison 1 (19%). Minimum number of complications was observed in the main group (6%). Acute pancreatitis was diagnosed in groups of clinical comparison 1 and 2 as a rule, whereas only 3% of patients had this complication in the main group. Cholangitis was predominantly observed in the group of clinical comparison 2, in other groups this complication occurred in 3% of patients. Bleeding was observed only in the groups of clinical comparison 1 and 2 (10 and 13%, respectively). Loss of the lithotripter rope (3%) was detected only in the group of clinical comparison 2.
CONCLUSION
Endoscopic partial papillosphincterotomy with balloon dilatation is advisable for choledocholithiasis due to minimal risk of intra- and postoperative complications.
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