To compare the clinical efficacy and safety of endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilatation (EPBD) in the treatment of extrahepatic bile duct stones.

Clinical data of 92 patients with extrahepatic bile duct stones receiving minimally invasive treatments in Zengcheng District People's Hospital of Guangzhou from January 2016 to May 2020 were retrospectively analyzed. Among them, 56 patients were male and 36 female, aged (59±5) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients were divided into the EST group (n=45) and EPBD group (n=47) according to different treatments. Clinical efficacy and incidence of postoperative complications were observed in two groups. The incidence of postoperative complications was statistically compared between two groups by Chi-square test. The length of hospital stay and hospitalization expense were compared by t test.

The complete stone removal rate in EST group was 98%(44/45), significantly higher than 85%(40/47) in EPBD group (χ²=4.649, P<0.05). The incidence of postoperative acute pancreatitis in EST group was 7%(3/45), significantly lower compared with 21%(10/47) in EPBD group (χ²=4.753, P<0.05). The incidence of postoperative bleeding in EST group was 31%(14/45), significantly higher than 13%(6/47) in EPBD group (χ²=4.548, P<0.05). The length of postoperative hospital stay and hospitalization expense in the EST group were (9.4±1.4) d and (3.59±0.28)×10⁴ Yuan, significantly higher than (6.0±0.9) d and (3.02±0.27)×10⁴ Yuan in EPBD group (t=5.708, 4.166; P<0.05).

Both EST and EPBD are safe and efficacious minimally invasive therapies for extrahepatic bile duct stones. EST yields higher stone removal rate and lower incidence of postoperative acute pancreatitis, whereas EPBD can protect Oddi sphincter function to the greatest extent, and has multiple advantages such as low incidence of bleeding and rapid recovery.