XXXX versus sphincterotomy alone for the extraction of complex lithiasis: A prospective analysis.

@entity1 @entity384 @entity9279
BACKGROUND AND PURPOSE: Mid-size sphincterotomy associated with @entity384 is an alternative to wide @entity9279 . 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 @entity1 with complex stones were included. Group A underwent mid-size sphincterotomy associated with @entity384 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 @entity1 and group B comprised 69 @entity1 . Overall success rate for extraction was 86.4% in group A and 70% in group B (p = 0.069). In @entity9279 , 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: @entity384 is more effective and equally safe than conventional sphincterotomy for the management of giant main bile duct lithiasis.
