Jun Suk Park1, Tae Nyeun Kim, Kook Hyun Kim. 1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung 5-dong, Nam-gu, Daegu, Korea.
Abstract
BACKGROUND AND AIMS: Endoscopic sphincterotomy (ES) and endoscopic papillary large balloon dilation (EPLBD) are well-known procedures for the treatment of common duct stones. There was no statistically significant difference in post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis rates between ES and EPLBD in most studies. The aims of this study were to evaluate whether EPLBD increases the risk of post-ERCP pancreatitis and to identify the risk factors influencing post-ERCP pancreatitis. METHODS: A review of 341 patients who underwent ERCP for treatment of common duct stones larger than 1 cm in diameter from January 2006 to December 2011 was conducted retrospectively. Patients were divided into three groups: ES group (n = 207), EPLBD + ES group (n = 99), and EPLBD with previous history of ES group (n = 35). RESULTS: Of 341 patients, overall incidence of post-ERCP pancreatitis was 2.6% (n = 9). Incidence of post-ERCP pancreatitis was 3.4, 2.0, and 0% in the ES group, EPLBD + ES group, and EPLBD with previous history of ES group, respectively. No significant difference in the incidence of post-ERCP pancreatitis was observed among the three groups (p = 0.47). Endoscopic biliary stenting was the independent risk factor for pancreatitis according to univariate (p = 0.046) and multivariate analyses (p = 0.036, OR 4.211, 95% CI 1.095-16.199). Age, sex, stone size, mechanical lithotripsy, common bile duct diameter, balloon size, and duration of balloon dilation were not significantly related to post-ERCP pancreatitis. CONCLUSION: EPLBD with antecedent limited ES or previous ES state does not increase the risk of post-ERCP pancreatitis in patients with large bile duct stones. Endoscopic biliary stenting seems to be the independent risk factor of post-ERCP pancreatitis.
BACKGROUND AND AIMS: Endoscopic sphincterotomy (ES) and endoscopic papillary large balloon dilation (EPLBD) are well-known procedures for the treatment of common duct stones. There was no statistically significant difference in post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis rates between ES and EPLBD in most studies. The aims of this study were to evaluate whether EPLBD increases the risk of post-ERCP pancreatitis and to identify the risk factors influencing post-ERCP pancreatitis. METHODS: A review of 341 patients who underwent ERCP for treatment of common duct stones larger than 1 cm in diameter from January 2006 to December 2011 was conducted retrospectively. Patients were divided into three groups: ES group (n = 207), EPLBD + ES group (n = 99), and EPLBD with previous history of ES group (n = 35). RESULTS: Of 341 patients, overall incidence of post-ERCP pancreatitis was 2.6% (n = 9). Incidence of post-ERCP pancreatitis was 3.4, 2.0, and 0% in the ES group, EPLBD + ES group, and EPLBD with previous history of ES group, respectively. No significant difference in the incidence of post-ERCP pancreatitis was observed among the three groups (p = 0.47). Endoscopic biliary stenting was the independent risk factor for pancreatitis according to univariate (p = 0.046) and multivariate analyses (p = 0.036, OR 4.211, 95% CI 1.095-16.199). Age, sex, stone size, mechanical lithotripsy, common bile duct diameter, balloon size, and duration of balloon dilation were not significantly related to post-ERCP pancreatitis. CONCLUSION: EPLBD with antecedent limited ES or previous ES state does not increase the risk of post-ERCP pancreatitis in patients with large bile duct stones. Endoscopic biliary stenting seems to be the independent risk factor of post-ERCP pancreatitis.
Authors: T Rabenstein; H T Schneider; M Nicklas; T Ruppert; A Katalinic; E G Hahn; C Ell Journal: Gastrointest Endosc Date: 1999-11 Impact factor: 9.427
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Authors: James A Disario; Martin L Freeman; David J Bjorkman; Padraic Macmathuna; Bret T Petersen; Philip E Jaffe; Thomas G Morales; Lee J Hixson; Stuart Sherman; Glen A Lehman; M Mazen Jamal; Firas H Al-Kawas; Mukul Khandelwal; Joseph P Moore; Gregory A Derfus; Priya A Jamidar; Francisco C Ramirez; Michael E Ryan; Karen L Woods; David L Carr-Locke; Stephen C Alder Journal: Gastroenterology Date: 2004-11 Impact factor: 22.682