TY - JOUR
T1 - Large-diameter biliary orifice balloon dilation to aid in endoscopic bile duct stone removal
T2 - a multicenter series
AU - Attasaranya, Siriboon
AU - Cheon, Young Koog
AU - Vittal, Harsha
AU - Howell, Douglas A.
AU - Wakelin, Donald E.
AU - Cunningham, John T.
AU - Ajmere, Niraj
AU - Ste Marie, Ronald W.
AU - Bhattacharya, Kanishka
AU - Gupta, Kapil
AU - Freeman, Martin L.
AU - Sherman, Stuart
AU - McHenry, Lee
AU - Watkins, James L.
AU - Fogel, Evan L.
AU - Schmidt, Suzette
AU - Lehman, Glen A.
PY - 2008/6
Y1 - 2008/6
N2 - Background: The utility and safety of endoscopic biliary orifice balloon dilation (EBD) for bile duct stone removal (with use of large-diameter balloons) after biliary endoscopic sphincterotomy (BES) is currently not well established. Objective: Our purpose was to evaluate the efficacy and complications of BES followed by ≥12 mm diameter EBD for bile duct stone removal. Design: Retrospective, multicenter series. Setting: Five ERCP referral centers in the United States. Patients and Interventions: Patients who underwent attempted removal of bile duct stones by BES followed by EBD with ≥12 mm diameter dilating balloons were identified by searching the prospectively recorded endoscopic databases from 1999 to 2007. Clinical parameters, endoscopic data, and outcomes were collected and analyzed. Results: One hundred three patients, mean age 70 ± 17 years (range 23-98 years), with 56 (54%) women, underwent 107 procedures. Eleven patients (11%) had a prior history of acute pancreatitis. Pancreatogram was performed in 15 (14%) patients. Median stone size and median balloon diameter used was 13 mm. Complete stone removal in the first session of EBD was accomplished in 102 (95%) procedures, and mechanical lithotripsy was required in 29 (27%). Six patients (5.4%) had documented procedure-related complications including one patient with severe bleeding and one with severe cystic duct perforation. No acute pancreatitis occurred. Conclusion: EBD with a large-diameter balloon in conjunction with BES for bile duct stone removal is effective and relatively safe. This technique appears to be a reasonable alternative option when standard BES and basket or balloon sweep are inadequate to remove bile duct stones.
AB - Background: The utility and safety of endoscopic biliary orifice balloon dilation (EBD) for bile duct stone removal (with use of large-diameter balloons) after biliary endoscopic sphincterotomy (BES) is currently not well established. Objective: Our purpose was to evaluate the efficacy and complications of BES followed by ≥12 mm diameter EBD for bile duct stone removal. Design: Retrospective, multicenter series. Setting: Five ERCP referral centers in the United States. Patients and Interventions: Patients who underwent attempted removal of bile duct stones by BES followed by EBD with ≥12 mm diameter dilating balloons were identified by searching the prospectively recorded endoscopic databases from 1999 to 2007. Clinical parameters, endoscopic data, and outcomes were collected and analyzed. Results: One hundred three patients, mean age 70 ± 17 years (range 23-98 years), with 56 (54%) women, underwent 107 procedures. Eleven patients (11%) had a prior history of acute pancreatitis. Pancreatogram was performed in 15 (14%) patients. Median stone size and median balloon diameter used was 13 mm. Complete stone removal in the first session of EBD was accomplished in 102 (95%) procedures, and mechanical lithotripsy was required in 29 (27%). Six patients (5.4%) had documented procedure-related complications including one patient with severe bleeding and one with severe cystic duct perforation. No acute pancreatitis occurred. Conclusion: EBD with a large-diameter balloon in conjunction with BES for bile duct stone removal is effective and relatively safe. This technique appears to be a reasonable alternative option when standard BES and basket or balloon sweep are inadequate to remove bile duct stones.
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U2 - 10.1016/j.gie.2007.08.047
DO - 10.1016/j.gie.2007.08.047
M3 - Article
C2 - 18178208
AN - SCOPUS:44149094649
SN - 0016-5107
VL - 67
SP - 1046
EP - 1052
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 7
ER -