Back to Search
Start Over
Long-term outcomes of endoscopic papillary large-balloon dilation (12-15 mm) with or without limited sphincterotomy for removal of bile duct stones.
- Source :
-
Hepatobiliary & pancreatic diseases international : HBPD INT [Hepatobiliary Pancreat Dis Int] 2023 Aug; Vol. 22 (4), pp. 392-398. Date of Electronic Publication: 2022 Jul 09. - Publication Year :
- 2023
-
Abstract
- Background: Limited endoscopic sphincterotomy with large balloon dilation (ES-LBD) and endoscopic papillary large-balloon dilation (EPLBD) have been proven safe and effective for removal of bile duct stones. However, the long-term outcomes are not clear. The aim of this study was to assess the long-term outcomes of EPLBD (12-15 mm) with or without limited sphincterotomy for removal of common bile duct (CBD) stones.<br />Methods: Patients with EPLBD or ES-LBD referred for the removal of bile-duct stones between June 2008 and August 2020 were retrospectively reviewed. Complete stone clearance, endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events, and late biliary complications during long-term follow-up were analyzed.<br />Results: Basic patient characteristics were not significantly different between the groups that underwent EPLBD (n = 168) and ES-LBD (n = 57). EPLBD compared with ES-LBD resulted in similar outcomes in terms of overall successful stone removal (99.4% vs. 100%, P = 1.00) and ERCP-related adverse events (7.7% vs. 5.3%, P = 0.77). The mean duration of the follow-up were 113.6 months and 106.7 months for patients with EPLBD and ES-LBD, respectively (P = 0.13). There was no significant difference between EPLBD and ES-LBD in the incidence of stone recurrence [20 (11.9%) vs. 9 (15.8%); P = 0.49]. Multivariate analysis showed that a diameter of CBD ≥ 15 mm (OR = 3.001; 95% CI: 1.357-6.640; P = 0.007) was an independent risk factor for stone recurrence.<br />Conclusions: The application of a large balloon (12-15 mm) via EPLBD is an effective and safe alternative to ES-LBD for extraction of large CBD stones. Endoscopic sphincterotomy prior to EPLBD may be unnecessary. A diameter of CBD ≥ 15 mm is a risk factor of stone recurrence.<br /> (Copyright © 2022. Published by Elsevier B.V.)
- Subjects :
- Humans
Retrospective Studies
Dilatation
Treatment Outcome
Cholangiopancreatography, Endoscopic Retrograde adverse effects
Cholangiopancreatography, Endoscopic Retrograde methods
Sphincterotomy, Endoscopic adverse effects
Sphincterotomy, Endoscopic methods
Gallstones diagnostic imaging
Gallstones surgery
Choledocholithiasis diagnostic imaging
Choledocholithiasis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1499-3872
- Volume :
- 22
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Hepatobiliary & pancreatic diseases international : HBPD INT
- Publication Type :
- Academic Journal
- Accession number :
- 35851505
- Full Text :
- https://doi.org/10.1016/j.hbpd.2022.07.003