Endoscopic balloon dilation compared with sphincterotomy for extraction of bile duct stones

DiSario, James A.; Freeman, Martin L.; Bjorkman, David J.; MacMathúna, Padraic; Petersen, Bret T.; Jaffe, Philip E.; Morales, Thomas G.; Hixson, Lee J.; Sherman, Stuart; Lehman, Glen A.; Jamal, M. Mazen; Al‐Kawas, Firas H.; Khandelwal, Mamta; Moore, Joseph P.; Derfus, Gregory; Jamidar, Priya A.; Ramirez, Francisco C.; Ryan, Michael E.; Woods, Karen; Carr‐Locke, David L.; Alder, Stephen C.

doi:10.1053/j.gastro.2004.07.017

Cited by 347 publications

(232 citation statements)

References 34 publications

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“…The incidence of acute pancreatitis was practically identical in both groups (1.9% in the ES with SP group versus 2% in the ES group), and in no case did we use pancreatic stents. This appears to confirm the findings in the literature to the effect that dilatation after ES results in far lower pancreatitis rates than when only performing SP [13,17,25,26]. Probably, the inflammatory reaction caused by SP, which can affect drainage of the pancreatic duct, is mitigated by the effect of previous ES, which separates the pancreatic and biliary orifices.…”

Section: Discussionsupporting

confidence: 88%

Efficacy and safety of sphincterotomy with sphincteroplasty using large caliber balloons in the treatment of choledocholithiasis with extraction difficulties

Uribarrena-Amezaga¹,

Serna²,

Calvo-Morillas³

et al. 2013

OJGas

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Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) is the most widely used technique for treating choledocholithiasis.In some cases, due to anomalies of the papilla or the presence of large or multiple calculi, additional maneuvers are needed to remove the stones. The present study investigates the efficacy and safety of ES with sphincteroplasty (SP) in the management of choledocholithiasis with extraction difficulties. Patients and Methods: A prospective study was made of 153 patients with choledocholithiasis subjected to ERCP. Fifty-two patients underwent ES with SP, while 101 were subjected only to ES. The two groups were compared in terms of age, gender, percentage cannulation, presence of papilla alterations, large or multiple stones, success in stone removal and complications (acute pancreatitis, bleeding and perforation). In the ES with SP group, we moreover recorded the diameters of the balloons employed (10 -18 mm). Results: There were no significant differences between the groups in the stone extraction success rate (94.23% in the ES with SP group versus 97.03% in the ES group) or in the appearance of complications (3.8% in the ES with SP group versus 2.7% in the ES group). The presence of difficult papillae, and of multiple or large stones was significantly greater in the ES with SP group. The diameter of the balloon was not associated with the appearance of complications. Conclusion: Endoscopic sphincterotomy with sphincteroplasty is effective and safe in the treatment of choledocholithiasis with extraction difficulties.

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Section: Discussionsupporting

confidence: 88%

Efficacy and safety of sphincterotomy with sphincteroplasty using large caliber balloons in the treatment of choledocholithiasis with extraction difficulties

Uribarrena-Amezaga¹,

Serna²,

Calvo-Morillas³

et al. 2013

OJGas

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“…Older studies have reported lower rates of pancreatitis (19,20), but in our study we are possibly including many more cases of asymptomatic, biochemical pancreatitis that are diagnosed on the basis of routine determination of blood values of pancreatic enzymes after the procedure (21).…”

Section: Discussionmentioning

confidence: 99%

Tendencies and outcomes in endoscopic biliary sphincterotomies among people with or without type 2 diabetes mellitus in Spain, 2003-2013

et al. 2016

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We aimed to compare incidence and outcomes for endoscopic biliary sphincterotomies in people with or without type 2 diabetes mellitus (T2DM) in Spain (2003Spain ( -2013.We collected all cases of endoscopic biliary sphincterotomies using national hospital discharge data and evaluated annual incidence rates stratified by T2DM status. We analyzed trends over time for in-hospital mortality (IHM) as the primary outcome and a composite of IHM or procedure-related complications (key secondary outcome). In multivariate analyses, we tested T2DM as an independent factor of IHM and IHM or complications.We identified 126,885 endoscopic biliary sphincterotomies (23,002 [18.1%] in T2DM people). Crude incidence rates of endoscopic biliary sphincterotomies were > 3-fold higher in people with vs without T2DM (85.5/10 5 vs 26.9/10 5 population, respectively). Annual incidence rates of endoscopic biliary sphincterotomies showed 11-year relative increments of 77.5% (from 60.0 to 106.5/105) in T2DM, and 53.7% (from 21.6 to 33.2/105) in non-T2DM people (p < 0.001). We found no significant changes in mortality trends over time for the populations with or without T2DM (p = 0.15 and p = 0.21, respectively). Rates of procedural pancreatitis decreased in people without T2DM (p < 0.001). In the multivariate analysis, older age, higher comorbidity and endoscopic biliary sphincterotomy during urgent admission were associated with a higher IHM. T2DM was associated with a lower IHM after an endoscopic biliary sphincterotomy Further studies are needed to confirm a lower IHM for endoscopic biliary sphincterotomies in people with T2DM.

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“…Accordingly, dilatation was performed to a maximum of 8 mm in this study. A marked increase in post-ERCP pancreatitis was noted in the dilation group (15 vs. 1 %), including a 5 % risk of severe pancreatitis (none in the EST group) and two deaths from acute pancreatitis in 117 patients in the balloon dilation arm [8].…”

mentioning

confidence: 90%

Endoscopic Removal of Large Common Bile Duct Stones: Time to Arm the Laser?

Heller

2012

Dig Dis Sci

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Endoscopic balloon dilation compared with sphincterotomy for extraction of bile duct stones

Cited by 347 publications

References 34 publications

Efficacy and safety of sphincterotomy with sphincteroplasty using large caliber balloons in the treatment of choledocholithiasis with extraction difficulties

Efficacy and safety of sphincterotomy with sphincteroplasty using large caliber balloons in the treatment of choledocholithiasis with extraction difficulties

Tendencies and outcomes in endoscopic biliary sphincterotomies among people with or without type 2 diabetes mellitus in Spain, 2003-2013

Endoscopic Removal of Large Common Bile Duct Stones: Time to Arm the Laser?

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