To evaluate the efficacy and safety of minor endoscopic sphincterotomy(EST) with endoscopic papillary large balloon dilation(EPLBD) for common bile duct stones(CBDS) in elderly patients and to study the influence of the periampullary diverticula on efficacy.

Data of 209 patients with CBD stones(more than 1.0 cm) over the age of 70 were retrospectively analyzed. The patients were divided into EST group (103 cases) and the EST with EPLBD group (106 cases), which was further divided into two subgroups with and without periampullary diverticula.Operation time, complete stone removal rate in the first session, mechanical lithotripsy usage rate and complications were compared between the two groups.

Compared with EST group, the EST with EPLBD group had shorter operation time [(25.65±8.76)min VS(35±6.67)min, P=0.000], a higher success rate of the complete stone removal in the first session (90.57% VS 83.50%, P=0.030), lower rate of mechanical lithotripsy (8.50% VS 55.34%, P=0.000), but with a higher incidence of hyperamylemia(18/106 VS 7/103, P=0.044). The overall stone removal rates showed no difference (96.23% VS 95.14%, P=0.700). In the EPLBD group, diverticulum had no effects on the results and complications of ERCP (P>0.05).

EST with EPLBD is a safe and effective method for CBDS in elderly patients. Periampullary diverticula does not affect the therapeutic effects of this method.

Choledocholithiasis; Minor endoscopic sphincterotomy; Endoscopic papillary large balloon dilation