Efficacy of endoscopic large balloon dilation extended for 2 minutes in bile duct stone removal: A multicenter retrospective study. (7th August 2021)

• Record Type: Journal Article
• Authors: Nakahara, Kazunari; Michikawa, Yosuke; Suetani, Keigo; Sato, Junya; Igarashi, Yosuke; Sekine, Akihiro; Kobayashi, Shinjiro; Matsuda, Koji; Otsubo, Takehito; Itoh, Fumio
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 29:Number 8(2022)
• Page Start: 932
• Page End: 940
• Publication Date: 2021-08-07
• Subjects: acute pancreatitis -- adverse event -- bile duct stone -- endoscopic papillary large balloon dilation -- endoscopic retrograde cholangiopancreatography; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.1029
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background/Purpose: There is no evidence regarding the optimal balloon dilation time during endoscopic papillary large balloon dilation (EPLBD). The study aim was to evaluate the efficacy of 2‐minute extended balloon dilation for EPLBD. Methods: Two hundred and five patients who underwent EPLBD during endoscopic retrograde cholangiopancreatography (ERCP) for bile duct stones at three tertiary centers were included in the analysis. Clinical outcomes and the adverse events were compared between the 0‐minute group (n = 94, balloon deflated immediately after waist disappearance) and the 2‐minute group (n = 111, balloon dilation maintained for 2 minutes after waist disappearance). The risk factors of post‐ERCP pancreatitis (PEP) after EPLBD were assessed. Results: There were no significant differences in the stone removal rates and hospitalization periods between the two groups. However, the total ERCP procedure time was significantly shorter in the 2‐minute group (40.6 vs 48.9 min, P = .03). The incidence of PEP was 7.4% in the 0‐minute group and significantly lower at 0.9% in the 2‐minute group ( P = .04). Multivariate analysis identified without 2‐minute extended EPLBD as a significant risk factor of PEP (OR: 9.9, P = .045). Conclusions: Extension of EPLBD for 2 minutes helped prevent PEP and shortened the procedure time. Abstract : Nakahara et al evaluated the efficacy of a 2‐minute extension of the dilation time during endoscopic papillary large balloon dilation for bile duct stone removal. Extension of the balloon dilation for 2 minutes after waist disappearance could help prevent post‐endoscopic retrograde cholangiopancreatography pancreatitis and shorten the overall procedure time.