Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single‐centre experience

Ho, S. P. S.; Rayzan, Daniel; Fox, Adrian; Kalogeropoulos, George; Mackay, Sean; Hassen, Sayed; Banting, Simon; Cade, Richard

doi:10.1111/ans.13058

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…Initial duct clearance rates with EST + EPLBD vary from 72.7% to 100% in published series[ 12 ] which are mainly from Asia. In a recent study from Australia[ 34 ] initial duct clearance rates were 70% in immediate EPLBD group and 74% in delayed EPLBD group.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic papillary large balloon dilatation with sphincterotomy is safe and effective for biliary stone removal independent of timing and size of sphincterotomy

Aujla

Ladep

Dwyer

et al. 2017

WJG

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AIMTo describe the efficacy and safety of endoscopic papillary large balloon dilatation (EPLBD) in the management of bile duct stones in a Western population.METHODSData was collected from the endoscopic retrograde cholangiopancreatography (ERCP) and Radiology electronic database along with a review of case notes over a period of six years from 1st August 2009 to 31st July 2015 and incorporated into Microsoft excel. Statistical analyses were performed using MedCalc for Windows, version 12.5 (MedCalc Software, Ostend, Belgium). Simple statistical applications were applied in order to determine whether significant differences exist in comparison groups. We initially used simple proportions to describe the study populations. Furthermore, we used chi-square test to compare proportions and categorical variables. Non-parametric Mann-Whitney U-test was applied in order to compare continuous variables. All comparisons were deemed to be statistically significant if P values were less than 0.05.RESULTSEPLBD was performed in 229 patients (46 females) with mean age of 68 ± 14.3 years. 115/229 (50%) patients had failed duct clearance at previous ERCP referred from elsewhere with standard techniques. Duct clearance at the Index* ERCP (1st ERCP at our centre) was 72.5%. Final duct clearance rate was 98%. EPLBD after fresh sphincterotomy was performed in 81 (35.4%). Median balloon size was 13.5 mm (10 - 18). In addition to EPLBD, per-oral cholangioscopy (POC) and electrohydraulic lithotripsy (EHL) was performed in 35 (15%) patients at index* ERCP. 63 (27.5%) required repeat ERCP for stone clearance. 28 (44.5%) required POC and EHL and 11 (17.4%) had repeat EPLBD for complete duct clearance. Larger stone size (12.4 mm vs 17.4 mm, P < 0.000001), multiple stones (2, range (1-13) vs 3, range (1-12), P < 0.006) and dilated common bile duct (CBD) (12.4 mm vs 18.3 mm, P < 0.001) were significant predictors of failed duct clearance at index ERCP. 47 patients (20%) had ampullary or peri-ampullary diverticula. Procedure related adverse events included 2 cases of bleeding and pancreatitis (0.87%) each.CONCLUSIONEPLBD is a safe and effective technique for CBDS removal. There is no difference in outcomes whether it is performed at the time of sphincterotomy or at a later procedure or whether there is a full or limited sphincterotomy.

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Section: Discussionmentioning

confidence: 99%

“…Major adverse events (AEs) related to EST and EPLBD are pancreatitis, bleeding, and perforation. A recent Australian retrospective study[ 34 ] reviewed outcomes of EPLBD and EST in 136 patients. Only one case of non-fatal pancreatitis and a perforation was observed in the delayed EPLBD group.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic papillary large balloon dilatation with sphincterotomy is safe and effective for biliary stone removal independent of timing and size of sphincterotomy

Aujla

Ladep

Dwyer

et al. 2017

WJG

View full text Add to dashboard Cite

show abstract

Esfinterotomía radial en colangiopancreatografía retrógrada endoscópica para manejo de coledocolitiasis de grandes elementos, experiencia institucional

Peña-Vergara,

Pinedo-Vega,

Pérez-Soriano

et al. 2024

Cirujano General

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Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single‐centre experience

Abstract: Our study suggests that use of a combined approach is safe and effective and may provide benefits over using endoscopic balloon dilatation or endoscopic sphincterotomy alone in the treatment of choledocholithiasis.

Cited by 2 publications

References 23 publications

Endoscopic papillary large balloon dilatation with sphincterotomy is safe and effective for biliary stone removal independent of timing and size of sphincterotomy

Endoscopic papillary large balloon dilatation with sphincterotomy is safe and effective for biliary stone removal independent of timing and size of sphincterotomy

Esfinterotomía radial en colangiopancreatografía retrógrada endoscópica para manejo de coledocolitiasis de grandes elementos, experiencia institucional

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