Balloon Dilation of the Sphincter of Oddi

Ra, Kozarek

doi:10.1055/s-2007-1018177

Cited by 95 publications

(33 citation statements)

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“…The combination of these techniques creates a large orifice facilitating removal of large or multiple stones with less chance of impaction in the distal bile duct [15] . In our study, the overall technical success of bile duct stone retrieval was 97%, and the success rate of complete stone retrieval in a single ERCP session (83%) was comparable to previous reports which ranged from 80% to 100% [10][11][12][13][14][15] . Considering that the average diameter of the bile duct stones was 17 mm, this outcome is clinically acceptable.…”

Section: Discussionsupporting

confidence: 77%

“…Endoscopic sphincterotomy (EST) has been accepted as the standard management for stone removal from the bile duct since its first description in 1974 [1] , however, it is associated with complications such as haemorrhage, pancreatitis, perforation, and recurrent infection of the biliary tree; it also causes permanent functional loss of the sphincter of Oddi in 1983 and has been advocated as an alternative to EST in selected patients with bile duct stones, despite a few reports of an unacceptably high risk of pancreatitis [4][5][6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic papillary large balloon dilation after limited sphincterotomy for difficult biliary stones

Rebelo

Moutinho-Ribeiro²,

Correia³

et al. 2012

WJGE

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AIM:To assess the efficacy and safety of endoscopic papillary large balloon dilation after biliary sphincterotomy for difficult bile duct stones retrieval. METHODS:Retrospective review of consecutive patients submitted to the technique during 18 mo. The main outcomes considered were: efficacy of the procedure (complete stone clearance; number of sessions; need of lithotripsy) and complications. RESULTS:A total of 30 patients with a mean age of 68 ± 10 years, 23 female (77%) and 7 male (23%) were enrolled. In 10 patients, a single stone was found in the common bile duct (33%) and in 20 patients multiple stones (67%) were found. The median diameter of the stones was 17 mm (12-30 mm). Dilations were performed with progressive diameter Through-TheScope balloons (up to 12, 15) or 18 mm. Complete retrieval of stones was achieved in a single session in 25 patients (84%) and in two sessions in 4 patients (13%). Failure occurred in 1 case (6%). Mechanical lithotripsy was performed in 6 cases (20%). No severe complications occurred. One patient (3%) had mild-grade post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. CONCLUSION:Endoscopic balloon dilatation with a large balloon after endoscopic sphincterotomy is a safe and effective technique that could be considered an alternative choice in therapeutic ERCP.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Endoscopic papillary large balloon dilation after limited sphincterotomy for difficult biliary stones

Rebelo

Moutinho-Ribeiro²,

Correia³

et al. 2012

WJGE

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“…13,20,30,32,33 Because of the significant occurrence of complications, Kozarek 34 insisted that EPBD should not replace EST. A randomized controlled study was finished prematurely due to excessive morbidity in the EPBD group (20.0% vs 10.0%).…”

Section: Complications 1) Post-epbd Pancreatitismentioning

confidence: 99%

Endoscopic Papillary Balloon Dilation for Removal of Choledocholithiasis: Indications, Advantages, Complications, and Long-Term Follow-Up Results

Chung¹,

Chung²

2011

Gut Liver

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Endoscopic papillary balloon dilation (EPBD) is an alternative method of endoscopic sphincterotomy (EST). Although concerns regarding post-procedure pancreatitis have been expressed, EPBD has come to be recognized as an effective and safe method for stone removal in specific cases. To analyze the proper indications, ideal methods, complications, and long-term follow-up results for EPBD, we reviewed articles about EPBD located through a search of the PubMed data base. We analyzed the ballooning methods, indications, results and complications of EPBD among the articles found and compared the results with those of EST. We considered the authors' own clinical experience and knowledge in developing recommendations for EPBD. EPBD showed similar effi cacy and safety for the removal of choledocholithiasis to that of EST. Although large or multiple stones were diffi cult to remove by EPBD, it was safer and easier to apply in patients with coagulopathy or abnormal anatomy. To prevent severe pancreatitis, excessive ballooning and impractical cannulation should be avoided, and precut sphincterotomy or adjuvant prophylaxis should be considered. Due to its preservation of the sphincter of Oddi, EPBD is expected to have fewer long-term complications, such as stone recurrence, cholangitis and cholecystitis. In conclusion, EPBD appears to be safe and effective for the treatment of choledocholithiasis with proper selection of ballooning methods and patients. (Gut Liver 2011;5:1-14)

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“…13 Endoscopic injection of botulinum toxin appears to predict the subsequent outcome of sphincterotomy and could be a useful therapy in a selection of patients, especially in the setting where manometry is not available. 14,15 Research has indicated a strong probability that processes in the PV affect its size, height and surface area, and also the function of the SOK. 16 -18 SOD was found to be perceived by 1% of patients after cholecystectomy, but 14% of patients developed the atypical symptoms of PCS after the operation.…”

Section: Skalicky Impact Of Cholecystectomy On the Papilla Of Vatermentioning

confidence: 99%

The Size of the Papilla of Vater and Its Relation to Its Height in Comparison with the Visibility of the Sphincter of Oddi before and after Cholecystectomy

Skalicky

2011

J Int Med Res

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This study investigated the changes in the surface area and height of the papilla of Vater (PV) and the visibility of the sphincter of Oddi complex (SOK) using endoscopic ultrasound (EUS) examinations of 80 patients with symptomatic gallstones before and at 3 and 6 months after cholecystectomy. Following surgery, 50 patients experienced early atypical symptoms characteristic of postcholecystectomy syndrome (PCS) and 30 patients were asymptomatic. The PV measurements were greater in all patients compared with normal reference values and increased significantly from before surgery to 3 months postsurgery. At 6 months postsurgery, both the surface area and height of the PV had significantly decreased to preoperative values but remained higher than normal. The proportion of patients with a visible SOK had increased by 3 months postsurgery but had reduced again by 6 months. There were no significant differences between symptomatic and asymptomatic patients, suggesting that the changes observed in the PV and SOK do not explain the presence of the atypical symptoms of PCS.

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Balloon Dilation of the Sphincter of Oddi

Cited by 95 publications

References 0 publications

Endoscopic papillary large balloon dilation after limited sphincterotomy for difficult biliary stones

Endoscopic papillary large balloon dilation after limited sphincterotomy for difficult biliary stones

Endoscopic Papillary Balloon Dilation for Removal of Choledocholithiasis: Indications, Advantages, Complications, and Long-Term Follow-Up Results

The Size of the Papilla of Vater and Its Relation to Its Height in Comparison with the Visibility of the Sphincter of Oddi before and after Cholecystectomy

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