Analysis of Clinical Effects of Intubation and Sphincterotomy With Wire-guided Incision Knife Plus Balloon Dilatation in the Treatment of Choledocholithiasis: A Randomized Controlled Trial

Background: To investigate the clinical effects of intubation and sphincterotomy with wire-guided incision knife plus balloon dilatation (ISBD) in the treatment of choledocholithiasis, a randomized controlled trial was conducted. Methods: A total of 270 patients with choledocholithiasis confirmed by computed tomography or magnetic resonance imaging from January 2016 to July 2018 in our hospital were enrolled in the research. All patients were randomly divided into 3 groups: ISBD group, endoscopic sphincterotomy (EST) group, and endoscopic sphincterotomy plus balloon dilation group, respectively. The clinical effects, complications, and inflammation indexes of the 3 groups were detected. SPSS software was used for statistics and analysis of results. Results: There were no significant differences in basic characteristics of the 3 groups. Although there was no significant difference in the total stone clearance rate among the 3 groups, the first stone clearance rate and the large stone clearance rate in ISBD group were significantly higher than those in EST group. Compared with the other 2 groups, the total operation time and complications in ISBD group were significant lower. The serum levels of interleukin-6, C-reactive protein (CRP), procalcitonin (PCT), carbohydrate antigen 19-9, and carcinoembryonic antigen in ISBD group were significant lower than those in EST group, and CRP and PCT in ISBD group were markedly lower than those in endoscopic sphincterotomy plus balloon dilation group. Conclusions: ISBD treatment simplifies the operation procedure, shortens the operation time, reduces postoperative inflammation and complications, and makes ERCP stone removal simpler, safer, and more efficient for patients with common bile duct stones.