BACKGROUND: Endoscopic papillary large balloon dilation (EPLBD) is safe and effective in management of common bile duct stones (CBDS). Endoscopic sphincterotomy (EST) prior to EPLBD has been performed as a standard procedure. However, the significance of EST prior to EPLBD has not been well studied yet. AIMS: To compare the clinical outcomes of EPLBD with and without EST to evaluate the significance of EST. METHODS: Between April 2010 and March 2015, a total of 82 patients with naïve papillae underwent EPLBD with or without EST for the management of CBDS. A retrospective analysis compared the efficacy and safety of EPLBD with and without EST. RESULTS: Basic patient characteristics were not significantly different between the groups that underwent EPLBD with EST (n = 27) and without EST (n = 55). Complete stone removal rates were similar between the groups (100 % in the EST group and 98 % in the non-EST group, p = 1.00). There was no significant difference in the median balloon size (13 mm in both groups, p = 0.445), rate of application of mechanical lithotripsy (26 vs. 35 % in the EST and non-EST groups, respectively, p = 0.463), or the median procedure time (38 vs. 34 min in the EST and non-EST groups, respectively, p = 0.682). The overall adverse event rates were not statistically different (4 vs. 7 % in the EST and non-EST groups, respectively, p = 1.00). Pancreatitis, cholangitis, and hemorrhage rates were also similar in both groups. CONCLUSIONS: EST prior to EPLBD may be unnecessary since this study did not demonstrate its benefits.
BACKGROUND: Endoscopic papillary large balloon dilation (EPLBD) is safe and effective in management of common bile duct stones (CBDS). Endoscopic sphincterotomy (EST) prior to EPLBD has been performed as a standard procedure. However, the significance of EST prior to EPLBD has not been well studied yet. AIMS: To compare the clinical outcomes of EPLBD with and without EST to evaluate the significance of EST. METHODS: Between April 2010 and March 2015, a total of 82 patients with naïve papillae underwent EPLBD with or without EST for the management of CBDS. A retrospective analysis compared the efficacy and safety of EPLBD with and without EST. RESULTS: Basic patient characteristics were not significantly different between the groups that underwent EPLBD with EST (n = 27) and without EST (n = 55). Complete stone removal rates were similar between the groups (100 % in the EST group and 98 % in the non-EST group, p = 1.00). There was no significant difference in the median balloon size (13 mm in both groups, p = 0.445), rate of application of mechanical lithotripsy (26 vs. 35 % in the EST and non-EST groups, respectively, p = 0.463), or the median procedure time (38 vs. 34 min in the EST and non-EST groups, respectively, p = 0.682). The overall adverse event rates were not statistically different (4 vs. 7 % in the EST and non-EST groups, respectively, p = 1.00). Pancreatitis, cholangitis, and hemorrhage rates were also similar in both groups. CONCLUSIONS: EST prior to EPLBD may be unnecessary since this study did not demonstrate its benefits.
Entities:
Keywords:
Adverse event; Common bile duct stone; Endoscopic papillary large balloon dilation; Endoscopic retrograde cholangiopancreatography; Endoscopic sphincterotomy; Pancreatitis
Authors: G Stefanidis; N Viazis; D Pleskow; S Manolakopoulos; L Theocharis; C Christodoulou; N Kotsikoros; J Giannousis; S Sgouros; M Rodias; A Katsikani; R Chuttani Journal: Am J Gastroenterol Date: 2010-11-02 Impact factor: 10.864
Authors: Peter B Cotton; Glenn M Eisen; Lars Aabakken; Todd H Baron; Matt M Hutter; Brian C Jacobson; Klaus Mergener; Albert Nemcek; Bret T Petersen; John L Petrini; Irving M Pike; Linda Rabeneck; Joseph Romagnuolo; John J Vargo Journal: Gastrointest Endosc Date: 2010-03 Impact factor: 9.427
Authors: Hyun Gun Kim; Young Koog Cheon; Young Deok Cho; Jong Ho Moon; Do Hyun Park; Tae Hoon Lee; Hyun Jong Choi; Sang-Heum Park; Joon Seong Lee; Moon Sung Lee Journal: World J Gastroenterol Date: 2009-09-14 Impact factor: 5.742