Endoscopic Papillary Balloon Dilation vs. Sphincterotomy for Removal of Common Bile Duct Stones: A Prospective Randomized Pilot Study

Arnold, Jayantha; Benz, C.; Martin, W.-R.; Adamek, Henning E.; Riemann, J. F.

doi:10.1055/s-2001-15307

Cited by 116 publications

(64 citation statements)

References 12 publications

(39 reference statements)

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“…While endoscopic sphincterotomy involves cutting and carries bleeding rates of 2% to 5%, balloon dilatation theoretically preserves the biliary sphincter with reported no bleeding and consequently balloon dilatation has shown to be safe even in patients with coagulopathies who normally carry a 6.6% to 14.3% mortality rate with endoscopic sphincterotomy. This is also in agreement with Arnold et al and Lin et al who found higher bleeding rates among ES group involving 26% and 7% respectively and 1.9% and 0% in EBD group respectively [14,15].…”

Section: Discussionsupporting

confidence: 82%

Endoscopic Balloon Dilatation vs. Sphincterotomy in Cases of Calcular Obstructive Jaundice during Endoscopic Retrograde Cholangio Pancreatography

Rasheed¹

2017

J Gastrointest Dig Syst

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Section: Discussionsupporting

confidence: 82%

Endoscopic Balloon Dilatation vs. Sphincterotomy in Cases of Calcular Obstructive Jaundice during Endoscopic Retrograde Cholangio Pancreatography

Rasheed¹

2017

J Gastrointest Dig Syst

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“…However, major limitations of EBD exist, including difficulty in removing large stones and a high incidence of pancreatitis. Since balloon dilation does not enlarge the sphincter of Oddi to the same extent as EST, large stone removal with EBD is difficult, and mechanical lithotripsy is required more often than with EST [11,21] . As a result, there is a need to modify the EBD technique to remove large bile duct stones and reduce the risk of pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

“…It has similar outcomes for common bile duct stone removal compared to EST, and has the advantages over EST of preserving papillary sphincter function and causing minimal complications such as hemorrhage and perforation [11][12][13][14][15][16][17][18][19] . Despite these advantages, EBD is associated with more severe and frequent occurrence of pancreatitis [20][21][22] . In addition, EBD has some technical difficulties for removing large stones because the biliary opening is not enlarged to the same degree as with EST [23] .…”

Section: Introductionmentioning

confidence: 99%

Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy

Kim¹,

Cheon²,

Cho³

et al. 2009

WJG

101

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AIM:To compare small sphincterotomy combined with endoscopic papillary large balloon dilation (SES + ELBD) and endoscopic sphincterotomy (EST) for large bile duct stones. METHODS:We compared prospectively SES + ELBD (group A, n = 27) with conventional EST (group B, n = 28) for the treatment of large bile duct stones (≥ 15 mm). When the stone could not be removed with a normal basket, mechanical lithotripsy was performed. We compared the rates of complete stone removal with one session and application of mechanical lithotripsy. CONCLUSION: SES + ELBD did not show significant benefits compared to conventional EST, especially for the removal of large (≥ 15 mm) bile duct stones. RESULTS:

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“…In a randomized controlled trial of treatment of bile duct stones involving 337 patients in the United States, pancreatitis occurred in 15.4% (5.1% severe) after balloon dilation vs 0.8% (none severe) after pull-type sphincterotomy (P < 0.01), with two deaths from severe pancreatitis after balloon dilation [48] . A study from Germany also found a high rate of pancreatitis after papillary balloon dilation [49] . Recommendations.…”

Section: Endoscopic Sphincterotomy (Es)mentioning

confidence: 99%

Pancreatits after endoscopic retrograde cholangio-pancreatography

Aziz

Lehman

2007

WJG

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Pancreatitis is the most common complication after endoscopic retrograde cholangio-pancreatography (ERCP); the reported incidence of this complication varies from less than 1% to 40%, but a rate of 4%-8% is reported in most prospective studies involving nonselected patients. Differences in criteria for defining pancreatitis, methods of data collection, and patient populations (i.e. number of high-risk patients included in the published series) are factors that are likely to affect the varying rates of post-ERCP pancreatitis. The severity of post-ERCP pancreatitis (PEP) can range from a minor inconvenience with one or two days of added hospitalization with full recovery to a devastating illness with pancreatic necrosis, multiorgan failure, permanent disability, and even death. Although, most episodes of PEP are mild (about 90%), a small percentage of patients (about 10%) develop moderate or severe pancreatitis. In the past, PEP was often viewed as an unpredictable and unavoidable complication, with no realistic strategy for its avoidance. New data have aided in stratification of patients into PEP risk categories and new measures have been introduced to decrease the risk of PEP. As most ERCPs are performed on an outpatient basis, the majority of patients will not develop PEP and can be discharged. Alternatively, early detection of those patients who will go on to develop PEP can guide decisions regarding hospital admission and aggressive management. In the last decade, great efforts have been addressed toward prevention of this complication. Points of emphasis have included technical measures, pharmacological prophylaxis, and patient selection. This review provides a comprehensive, evidence-based assessment of published data on PEP and current suggestions for its avoidance.© 2007 The WJG Press. All rights reserved.Key words: Endoscopic retrograde cholangiopancreatography; Post-ERCP pancreatitis Abdel Aziz AM, Lehman GA. Pacreatitis after endoscopic r e t r o g r a d e c h o l a n g i o -p a n c r e a t o g r a p h y . W o r l d J

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Endoscopic Papillary Balloon Dilation vs. Sphincterotomy for Removal of Common Bile Duct Stones: A Prospective Randomized Pilot Study

Cited by 116 publications

References 12 publications

Endoscopic Balloon Dilatation vs. Sphincterotomy in Cases of Calcular Obstructive Jaundice during Endoscopic Retrograde Cholangio Pancreatography

Endoscopic Balloon Dilatation vs. Sphincterotomy in Cases of Calcular Obstructive Jaundice during Endoscopic Retrograde Cholangio Pancreatography

Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy

Pancreatits after endoscopic retrograde cholangio-pancreatography

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