Objective  To compare the efficacy of small endoscopic sphincterotomy (SEST) combined with endoscopic papillary balloon dilatation (EPBD) and conventional endoscopic sphincterotomy (EST) in the treatment of choledocholithiasis.

  Methods  A total of 68 patients with choledocholithiasis admitted to our hospital were divided into two groups by random number table method, with 34 cases in each group. The observation group was given SEST combined with EPBD, while the control group performed conventional EST. The clinical therapeutic effect, stone extraction, serum amylase levels before and after surgery and incidence of complications were compared between the two groups.

  Results  The total effective rate in the observation group was 94.12%, and was 70.59% in the control group, and a significant difference was seen between groups (P < 0.05). The stone removal time of the observation group was significantly shorter, the success rate of the first stone removal was significantly higher, and the rates of mechanical lithotripsy and recurrence were significantly lower than that of the control group (P < 0.05). There was no statistical difference in the recurrence time between the two groups (P>0.05). No significant difference in serum amylase levels between the two groups before surgery were found(P>0.05), but its levels were significantly lower in the observation group at 3, and 24 h after surgery than that in the control group (P < 0.05). The incidence of complications in the observation group was significantly lower than that in the control group(P < 0.05).

  Conclusion  SEST combined with EPBD has higher efficacy in success rate and clinical total effective rate, and has little effect on serum amylase level, can reduce the incidence of complications and recurrence rate, and shorten time of stone extraction.