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- Title
Superiority of 10‑mm‑wide Balloon over 8‑mm‑wide Balloon in Papillary Dilation for Bile Duct Stones: A Matched Cohort Study.
- Authors
Dai Akiyama; Tsuyoshi Hamada; Hiroyuki Isayama; Yousuke Nakai; Takeshi Tsujino; Gyotane Umefune; Naminatsu Takahara; Dai Mohri; Hirofumi Kogure; Saburo Matsubara; Yukiko Ito; Natsuyo Yamamoto; Naoki Sasahira; Minoru Tada; Kazuhiko Koike
- Abstract
Background/Aims: Endoscopic papillary balloon dilation (EPBD) is a possible alternative to endoscopic sphincterotomy (EST) for common bile duct (CBD) stones. To date, 10‑ and 8‑mm EPBD have not been fully compared. Patients and Methods: Patients who underwent EPBD for CBD stones at two Japanese tertiary care centers between May 1994 and January 2014 were identified. Matched pairs with 10‑ and 8‑mm EPBD were generated. Short‑ and long‑term outcomes were compared between the two groups. Results: A total of 869 patients were identified (61 and 808 patients for 10‑ and 8‑mm EPBD, respectively), and 61 well‑balanced pairs were generated. The rate of complete stone removal within a single session was higher in the 10‑mm EPBD group than in the 8‑mm EPBD group (69% vs. 44%, P < 0.001), and use of lithotripsy was less frequent in the 10‑mm EPBD group (23% vs. 56%, P < 0.001). The rates of post‑ERCP pancreatitis were similar between the 10‑ and 8‑mm EPBD groups (11% vs. 8%). Cumulative biliary complication‑free rates were not statistically different between the two groups: 88% [95% confidence interval (CI): 79-97%] and 94% (95% CI: 88-100%) at 1 year and 69% (95% CI: 56-85%) and 80% (95% CI: 69-93%) at 2 years in the 10‑ and 8‑mm EPBD groups, respectively. In the 10‑mm EPBD group, ascending cholangitis was not observed, and pneumobilia was found in 5% of cases during the follow‑up period. Conclusions: EPBD using a 10‑mm balloon for CBD stones is safe and more effective than 8‑mm EPBD. The sphincter function is highly preserved after 10‑mm EPBD.
- Subjects
JAPAN; GALLSTONE treatment; ACADEMIC medical centers; BILE ducts; CATHETERIZATION; CHI-squared test; CONFIDENCE intervals; ENDOSCOPIC retrograde cholangiopancreatography; FISHER exact test; LITHOTRIPSY; LONGITUDINAL method; PANCREATITIS; SAFETY; STATISTICS; SURGICAL equipment; DATA analysis; TREATMENT effectiveness; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator; LOG-rank test
- Publication
Saudi Journal of Gastroenterology, 2015, Vol 21, Issue 4, p213
- ISSN
1319-3767
- Publication type
Article
- DOI
10.4103/1319-3767.161634