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
Yuji Fujita,
Akito Iwasaki,
Takamitsu Sato,
Toshio Fujisawa,
Yusuke Sekino,
Kunihiro Hosono,
Nobuyuki Matsuhashi,
Kentaro Sakamaki,
Atsushi Nakajima,
Kensuke Kubota
Affiliations
Yuji Fujita
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
Akito Iwasaki
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
Takamitsu Sato
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
Toshio Fujisawa
Department of Gastroenterology, NTT Tokyo Medical Center, Tokyo, Japan
Yusuke Sekino
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
Kunihiro Hosono
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
Nobuyuki Matsuhashi
Department of Gastroenterology, NTT Tokyo Medical Center, Tokyo, Japan
Kentaro Sakamaki
Department of Medical Statistic, Yokohama City University School of Medicine, Yokohama, Japan
Atsushi Nakajima
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
Kensuke Kubota
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
Background/AimsThere 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.Conclusion : sEPLBD is a useful and safe method for common bile duct stone removal in patients without DLBD.
