La SMSO (Sphinctérotomie avec macrodilatation du sphincter d’Oddi) dans le traitement des gros calculs de la voie biliaire principale : Expérience de l’Hôpital Militaire de Rabat (Maroc)

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URI: http://hdl.handle.net/2042/62693  |   DOI : 10.4267/2042/62693
Title: La SMSO (Sphinctérotomie avec macrodilatation du sphincter d’Oddi) dans le traitement des gros calculs de la voie biliaire principale : Expérience de l’Hôpital Militaire de Rabat (Maroc)
Author: Seddik, Hassan; Chakkor, Amal; Berrag, Sanaa; Beraida, Reda; Adioui, Tarik; Benkirane, Ahmed
Abstract: Endoscopic sphincterotomy is the standard therapy for common bile duct stone extraction. The rate of successful common bile duct (CBD) stone clearance approaches 90%. Large CBD stones may be difficult to remove after endoscopic sphincterotomy alone. In this case, lithotripsy techniques are used, especially mechanical lithotripsy. However, it is often technically difficult to perform and time-consuming. Aim: To evaluate the efficacy and safety of large balloon dilation post endoscopic sphincterotomy in the removal of large common bile duct stones. To analyze the associated factors influencing the success of this technique and to evaluate retrospectively the rate of avoided ML. Material and methods: Retrospective analysis involving patients with bile duct stones ≥15 mm. Associated factors were analyzed using logistic regression binary. Results: A total of 48 endoscopic sphincterotomy plus large-balloon dilatation procedures were performed in 48 patients. The feasibility was 100%, and full clearance of the common bile duct was achieved in a single session without using mechanical lithotripsy in 91.6% of the cases. Short term complications were observed in 3 patients (6.2%) (minimal hemorrhage). There were no perforations. The calculi extraction was impossible in 4 cases in which calculi mean diameter was 19±2 mm. We used biliary plastic prosthesis in two patients while the two others were referred to surgery. Conclusion: ESLBD after endoscopic sphincterotomy is a simple, reproducible and effective technique, associated with a low morbidity rate and helps in avoiding mechanical lithotripsy in 91.6% of the cases for the endoscopic extraction of large common bile duct stones. None of the analyzed factors appear to be associated with the success or failure of this technique.
Subject: Cholangiopancréatographie rétrograde endoscopique; Sphinctéroplastie; Lithiase de la voie biliaire principale; Endoscopic papillary large balloon dilation; Endoscopic sphincterotomy; Endoscopic retrograde cholangiopancreatography
Publisher: ALN Editions, Nancy, France
Date: 2017
Mis à jour: 2017-09-27

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