Tzung-Jiun Tsai1, Chiun-Ku Lin1, Kwok-Hung Lai1, Hoi-Hung Chan2, E-Ming Wang3, Wei-Lun Tsai1, Jin-Shiung Cheng1, Hsien-Chung Yu1, Wen-Chi Chen1, Ping-I Hsu1. 1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. 2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan, ROC. Electronic address: hoihungchan@gmail.com. 3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC.
Abstract
BACKGROUND: Whether preserving sphincter of Oddi (SO) function by endoscopic papillary balloon dilation (EPBD) is beneficial for preventing recurrent common bile duct stone disease (CBDS) is controversial. The aim of this study was to measure sphincter of Oddi (SO) function by using SO manometry, and to evaluate the association with recurrent CBDS. METHODS: Patients with suspected CBDS who underwent successful EPBD were included. These patients underwent SO manometry at two months after EPBD with bile duct clearance. They were regularly followed for recurrent CBDS. RESULTS: From January 2000 to December 2009, 185 patients received EPBD and SO manometry was included. There were 64% male with mean age of 65 ± 15.6 years. Mean ballooning inflation size was 1.1 ± 0.19 cm and mean ballooning time was 4.5 ± 0.85 min 55.7% had a sphincter of Oddi basal pressure (SOBP) of 0 mmHg, 16.2% < 10 mmHg, 26.5% 10-40 mmHg, and 1.6% > 40 mmHg. In multivariate analysis, EPBD with balloon ≥1.2 cm was the only factor for loss of SO function. Moreover, patients with preserved SO function had higher stone recurrence rate (15% vs. 5%, p = 0.034). CONCLUSION: EPBD using balloon ≥1.2 cm is a major factor for loss of SO function, which seems to reduce the risk of recurrent CBD stones.
BACKGROUND: Whether preserving sphincter of Oddi (SO) function by endoscopic papillary balloon dilation (EPBD) is beneficial for preventing recurrent common bile duct stone disease (CBDS) is controversial. The aim of this study was to measure sphincter of Oddi (SO) function by using SO manometry, and to evaluate the association with recurrent CBDS. METHODS:Patients with suspected CBDS who underwent successful EPBD were included. These patients underwent SO manometry at two months after EPBD with bile duct clearance. They were regularly followed for recurrent CBDS. RESULTS: From January 2000 to December 2009, 185 patients received EPBD and SO manometry was included. There were 64% male with mean age of 65 ± 15.6 years. Mean ballooning inflation size was 1.1 ± 0.19 cm and mean ballooning time was 4.5 ± 0.85 min 55.7% had a sphincter of Oddi basal pressure (SOBP) of 0 mmHg, 16.2% < 10 mmHg, 26.5% 10-40 mmHg, and 1.6% > 40 mmHg. In multivariate analysis, EPBD with balloon ≥1.2 cm was the only factor for loss of SO function. Moreover, patients with preserved SO function had higher stone recurrence rate (15% vs. 5%, p = 0.034). CONCLUSION: EPBD using balloon ≥1.2 cm is a major factor for loss of SO function, which seems to reduce the risk of recurrent CBD stones.