To investigate the effectiveness and safety of endoscopic papillary large–balloon dilation(EPLBD) for juxtapapillary duodenal diverticulum(JPD)combined with large common bile duct stones.

A total of 87 patients with juxtapapillary duodenal diverticulum and large common bile duct stones were randomly divided to 2 groups. Forty–five cases received endoscopic papillary large–balloon dilation(EPLBD group) as the treatment group, and 42 cases were treated by conventional endoscopic sphincterotomy(EST group) as the control group. The success rate of stone clearance in a single session, operation time, the rate of mechanical lithotripsy and complications were observed.

Stone clearance in a single session of 2 groups were 91.1%(EPLBD group)and 92.9%(EST group) respectively with no significant difference(P>0.05). The stone removal time were(25.48±7.92)min in EPLBD group and(35.56±9.23)min in EST group(P<0.05). The rate of mechanical lithotripsy were 16.3% and 34.6% in two groups with significant differences. Rates of bleeding, postoperrative pancreatitis and cholangitis in two groups were similar(P>0.05). No death happened in any group.

EPLBD is a safe and effective method for clearance of large common bile duct stones combined with juxtapapillary duodenal diverticulum which can reduce the occurrence of mechanically breaking stone and operation time.

Choledocholithiasis; Juxtapapillary duodenal diverticulim; Sphincterotomy; Ballon dilatation