The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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The Ballooning Time in Endoscopic Papillary Balloon Dilation for the Treatment of Bile Duct Stones

  • Bang, Byoung-Wook (Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Jeong, Seok (Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Lee, Don-Haeng (Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Lee, Jung-Il (Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Lee, Jin-Woo (Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Kwon, Kye-Sook (Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Kim, Hyung-Gil (Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Shin, Yong-Woon (Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Kim, Young-Soo (Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine)
  • Received : 2010.01.18
  • Accepted : 2010.04.16
  • Published : 2010.09.01
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Abstract

Background/Aims: Endoscopic papillary balloon dilation (EPBD) is a safe and effective method for the treatment of choledocholithiasis, but previous studies have rarely reported the appropriate ballooning time (BT). We prospectively evaluated the safety and efficacy of EPBD according to BT in patients undergoing bile duct stone removal. Methods: Seventy consecutive patients with bile duct stones were randomly assigned to receive EPBD with either conventional (n = 35, 60 seconds) or short (n = 35, 20 seconds) BT. Results: EPBD alone achieved complete bile duct clearance in 67 patients (long BT, n = 33, 94.3%; short BT, n = 34, 97.1%; p = 0.808). We also found no significant difference in the rate of complete duct clearance, including procedures that used mechanical lithotripsy, between the long and short BT groups (97.1% vs. 100%; p = 0.811). Mild pancreatitis was noted in four (11.4%) patients in the long BT group and two (5.7%) patients in the short BT group, but this incidence was not significantly different. Conclusions: The study showed that EPBD using both 20-sec and 60-sec BTs is safe and effective for the treatment of bile duct stones. Short and long BTs produced comparable outcomes.

Keywords

Acknowledgement

Supported by : Inha University

References

  1. Fujita N, Maguchi H, Komatsu Y, et al. Endoscopic sphincterotomy and endoscopic papillary balloon dilatation for bile duct stones: a prospective randomized controlled multicenter trial. Gastrointest Endosc 2003;57:151-155. https://doi.org/10.1067/mge.2003.56
  2. Baron TH, Harewood GC. Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: a metaanalysis of randomized, controlled trials. Am J Gastroenterol 2004;99:1455-1460. https://doi.org/10.1111/j.1572-0241.2004.30151.x
  3. Disario JA, Freeman ML, Bjorkman DJ, et al. Endoscopic balloon dilation compared with sphincterotomy for extraction of bile duct stones. Gastroenterology 2004;127:1291-1299. https://doi.org/10.1053/j.gastro.2004.07.017
  4. Park DH, Kim MH, Lee SK, et al. Endoscopic sphincterotomy vs. endoscopic papillary balloon dilation for choledocholithiasis in patients with liver cirrhosis and coagulopathy. Gastrointest Endosc 2004;60:180-185. https://doi.org/10.1016/S0016-5107(04)01554-8
  5. Toda N, Saito K, Wada R, et al. Endoscopic sphincterotomy and papillary balloon dilation for bile duct stones. Hepatogastroenterology 2005;52:700-704.
  6. Sato H, Kodama T, Takaaki J, et al. Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry. Gut 1997;41:541-544. https://doi.org/10.1136/gut.41.4.541
  7. Yasuda I, Tomita E, Enya M, Kato T, Moriwaki H. Can endoscopic papillary balloon dilation really preserve sphincter of Oddi function? Gut 2001;49:686-691. https://doi.org/10.1136/gut.49.5.686
  8. Isayama H, Komatsu Y, Inoue Y, et al. Preserved function of the Oddi sphincter after endoscopic papillary balloon dilation. Hepatogastroenterology 2003;50:1787-1791.
  9. Tsujino T, Kawabe T, Isayama H, et al. Efficacy and safety of lowpressured and short-time dilation in endoscopic papillary balloon dilation for bile duct stone removal. J Gastroenterol Hepatol 2008;23:867-871. https://doi.org/10.1111/j.1440-1746.2007.05267.x
  10. Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc 1991;37:383-393. https://doi.org/10.1016/S0016-5107(91)70740-2
  11. Natsui M, Narisawa R, Motoyama H, et al. What is an appropriate indication for endoscopic papillary balloon dilation? Eur J Gastroenterol Hepatol 2002;14:635-640. https://doi.org/10.1097/00042737-200206000-00008
  12. Sugiyama M, Atomi Y. Follow-up of more than 10 years after endoscopic sphincterotomy for choledocholithiasis in young patients. Br J Surg 1998;85:917-921. https://doi.org/10.1046/j.1365-2168.1998.00750.x
  13. Wojtun S, Gil J, Gietka W, Gil M. Endoscopic sphincterotomy for choledocholithiasis: a prospective single-center study on the short-term and long-term treatment results in 483 patients. Endoscopy 1997;29:258-265. https://doi.org/10.1055/s-2007-1004186
  14. Nakagawa H, Ohara K. Safeguards against acute pancreatitis associated with endoscopic papillary balloon dilatation. J Hepatobiliary Pancreat Surg 2006;13:75-79. https://doi.org/10.1007/s00534-005-1061-5
  15. Seo DW. Prospective analysis of endoscopic papillary balloon dilatation and endoscopic sphincterotomy for removal of common bile duct stones. Gastrointest Endosc 2000;52:140-142.
  16. Vlavianos P, Chopra K, Mandalia S, Anderson M, Thompson J, Westaby D. Endoscopic balloon dilatation versus endoscopic sphincterotomy for the removal of bile duct stones: a prospective randomised trial. Gut 2003;52:1165-1169. https://doi.org/10.1136/gut.52.8.1165
  17. Ochi Y, Mukawa K, Kiyosawa K, Akamatsu T. Comparing the treatment outcomes of endoscopic papillary dilation and endoscopic sphincterotomy for removal of bile duct stones. J astroenterol Hepatol 1999;14:90-96. https://doi.org/10.1046/j.1440-1746.1999.01798.x
  18. Watanabe H, Yoneda M, Tominaga K, et al. Comparison between endoscopic papillary balloon dilatation and endoscopic sphincterotomy for the treatment of common bile duct stones. J Gastroenterol 2007;42:56-62. https://doi.org/10.1007/s00535-006-1969-9
  19. Bergman JJ, Rauws EA, Fockens P, et al. Randomised trial of endoscopic balloon dilation versus endoscopic sphincterotomy for removal of bileduct stones. Lancet 1997;349:1124-1129. https://doi.org/10.1016/S0140-6736(96)11026-6
  20. Mac Mathuna P, White P, Clarke E, Lennon J, Crowe J. Endoscopic sphincteroplasty: a novel and safe alternative to papillotomy in the management of bile duct stones. Gut 1994;35:127-129. https://doi.org/10.1136/gut.35.1.127
  21. Tulassay Z, Papp J, Koranyi L, Szathmari M, Tamas G Jr. Hormonal and biochemical changes following endoscopic retrograde cholangio-pancreatography. Acta Gastroenterol Belg 1981;44:538-544.
  22. Ueno N, Ozawa Y. Pancreatitis induced by endoscopic balloon sphincter dilation and changes in serum amylase levels after the procedure. Gastrointest Endosc 1999;49(4 Pt 1):472-476. https://doi.org/10.1016/S0016-5107(99)70045-3
  23. Pezzilli R, Romboli E, Campana D, Corinaldesi R. Mechanisms involved in the onset of post-ERCP pancreatitis. JOP 2002;3:162-168.
  24. Sugiyama M, Izumisato Y, Abe N, Masaki T, Mori T, Atomi Y. Predictive factors for acute pancreatitis and hyperamylasemia after endoscopic papillary balloon dilation. Gastrointest Endosc 2003;57:531-535. https://doi.org/10.1067/mge.2003.143
  25. Cheng CL, Sherman S, Watkins JL, et al. Risk factors for post- ERCP pancreatitis: a prospective multicenter study. Am J Gastroenterol 2006;101:139-147. https://doi.org/10.1111/j.1572-0241.2006.00380.x
  26. Freeman ML, DiSario JA, Nelson DB, et al. Risk factors for post- ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc 2001;54:425-434. https://doi.org/10.1067/mge.2001.117550
  27. Tsujino T, Kawabe T, Komatsu Y, et al. Endoscopic papillary balloon dilation for bile duct stone: immediate and long-term outcomes in 1000 patients. Clin Gastroenterol Hepatol 2007;5: 130-137. https://doi.org/10.1016/j.cgh.2006.10.013

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