Different Techniques for Management of Common Bile Duct Stones : A Single Centre Experience

Comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis

“…First, the inclusion criteria for CBDs varied across the trials, possibly leading to bias to this meta-analysis; meanwhile, the most common size was $10 mm, and it is different from the commonly clinical endoscopy practice (>15 mm), and we could not proceed with further analysis based on the size of stones because of the lack of more detailed data. Second, the maximum balloon diameter used in the included trials varied, the maximum balloon diameter used in Guo et al19 and El Wakil et al17 trials was 15 mm while maximum balloon diameter was 20 mm in the other trials; however, we were not sure whether the results would be affected by this difference. Third, only three of the included trials reported the use of post-endoscopy biliary drainage.…”

“…In terms of the use of ML, six studies13,16,17,19–21 provided data for this outcome with low heterogeneity ( I 2 =14%, P =0.32). The rate was lower in the EST with EPLBD group (36/330, 10.9%) than in the EPLBD alone group (42/338, 12.4%); however, the combined result was not statistically significant (OR =1.18, 95% CI=0.68–2.05, P =0.55) (Table 3, Figure 2B).…”

“…Seven trials were performed in three different countries (three in South Korea, two in China, and two in Egypt). For the study design of the seven including trials, Chu et al21 conducted a 4-arm parallel-group trial comparing the efficacies of EST alone, EPLBD alone, EST plus EPLBD, and EPLBD plus EST (EST plus EPLBD: EST followed by EPLBD, EPLBD plus EST: EPLBD followed by EST); El Wakil et al17 Sarhan et al18 and Guo et al19 conducted 3-arm trials comparing EST alone, EPLBD alone, EST with EPLBD, respectively. The remaining three studies13,16,20 performed in South Korea were 2-arm trials comparing EPLBD alone vs EPLBD following EST.…”

“…The inclusion criteria of CBDSs were the maximum CBDS size of at least ≥10 mm (found in most studies13,19,21 but ≥12 mm in two studies) 16,20. Only El Wakil et al17 took the occurrence of large and/or multiple CBDSs as an inclusion criterion of CBDS. The maximum balloon diameter used in the included studies ranged from 10 to 20 mm.…”