Gut Liver.  2017 Jan;11(1):149-155. 10.5009/gnl15634.

Feasibility of Endoscopic Papillary Large Balloon Dilation in Patients with Difficult Bile Duct Stones without Dilatation of the Lower Part of the Extrahepatic Bile Duct

• Fujita Y
• Iwasaki A
• Sato T
• Fujisawa T
• Sekino Y
• Hosono K
• Matsuhashi N
• Sakamaki K
• Nakajima A
• Kubota K

• KMID: 2412167
• DOI: http://doi.org/10.5009/gnl15634

Abstract

BACKGROUND/AIMS
There is no consensus for using endoscopic papillary large balloon dilation (EPLBD) in patients without dilatation of the lower part of the bile duct (DLBD). We evaluated the feasibility and safety of EPLBD for the removal of difficult bile duct stones (diameter ≥10 mm) in patients without DLBD.
METHODS
We retrospectively reviewed the records of 209 patients who underwent EPLBD for the removal of bile duct stones from October 2009 to July 2014. Primary outcomes were the clearance rate and additional mechanical lithotripsy. Secondary outcomes were the incidence of complications and recurrence rate.
RESULTS
Fifty-seven patients had DLBD (27.3%), and 152 did not have DLBD (72.7%). There were no significant differences in the overall success rate or the use of mechanical lithotripsy. Success rate during the first session and procedure time were better in the DLBD than the without-DLBD group (75.7% vs 66.7%, 48.1±23.0 minutes vs 58.4±31.7 minutes, respectively). As for complications, there were no significant differences in the incidence of pancreatitis, perforation or bleeding after endoscopic retrograde cholangiopancreatography. The recurrence rate did not differ significantly between the two groups.
CONCLUSIONS
EPLBD is a useful and safe method for common bile duct stone removal in patients without DLBD.

Keyword

Cholangiopancreatography, endoscopic retrograde; Common bile duct stone

MeSH Terms

Aged
Aged, 80 and over
Ampulla of Vater/*surgery
Bile Ducts, Extrahepatic/surgery
Cholangiopancreatography, Endoscopic Retrograde/*methods
Choledocholithiasis/*surgery
Dilatation/*methods
Feasibility Studies
Female
Humans
Male
Pancreatitis/epidemiology
Postoperative Complications/epidemiology
Postoperative Hemorrhage/epidemiology
Retrospective Studies