Endoscopic Sphincterotomy Plus Large Balloon Dilation Versus Endoscopic Sphincterotomy Alone for Patients with Common Bile Duct Stones: A GRADE Evaluation of Systematic Review and Meta-Analysis.
Mahmoud Mohamed Gad, Mohamed Ayman Salem, Muhammad Youssef et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy of endoscopic sphincterotomy with large-balloon dilation (ESBD) versus endoscopic sphincterotomy (ES) alone in adults with common bile duct stones. The analysis included 17 randomized controlled trials with 2671 patients. ESBD significantly improved first-session stone clearance (RR 1.11) and reduced mechanical lithotripsy use (RR 0.47) compared to ES alone.
Key findings
- ESBD improved first-session stone clearance (RR 1.11; 95% CI: 1.04 to 1.17; P = 0.001).
- Mechanical lithotripsy use was reduced with ESBD (RR 0.47; 95% CI: 0.34-0.65; P < 0.0001).
- Procedure time was shorter with ESBD (MD -3.44 min; 95% CI: -5.71 to -1.17; P = 0.003).
- Postoperative hemorrhage rates were lower with ESBD (RR 0.55; 95% CI 0.34 to 0.90; P = 0.02).
Why it matters
The findings suggest that ESBD may offer procedural advantages over ES alone, potentially leading to improved patient outcomes in the management of common bile duct stones. Understanding these differences can inform treatment decisions and patient management strategies.