Influence of Bile Duct Diameter on the Therapeutic Quality of Endoscopic Balloon Sphincteroplasty

Ohashi, Akiyoshi; Tamada, Kiichi; Tomiyama, Takeshi; Aizawa, Toshiyuki; Wada, Shinichi; Miyata, Takamitsu; Nishizono, Takashi; Tano, Shigeo; Sato, Yoshitoshi; Ueno, Nobuhiro; Ido, Kenichi; Kimura, Keishi

doi:10.1055/s-1999-13661

Cited by 17 publications

(19 citation statements)

References 6 publications

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“…When the forceps could not be smoothly inserted into the orifice of the papilla, an Olbert 5 French balloon tipped biliary catheter (Microvasive) with a length of 180 cm and a balloon length of 3 cm (maximum diameter 8 mm) was passed over the guidewire and endoscopic papillary balloon dilation (balloon sphincteroplasty) was performed using previously reported techniques. [37][38][39] During and after the biopsy, the guidewire remained in that position. Three or more specimens were obtained from each patient.…”

Section: Methodsmentioning

confidence: 99%

Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures

Tamada

Tomiyama

Wada

et al. 2002

Gut

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Background: When endoscopic retrograde cholangiopancreatography (ERCP) guided bile duct biopsy fails to demonstrate malignancy, it remains unclear how to manage patients with presumably malignant strictures. Aims: To evaluate the value of intraductal ultrasonography (IDUS) when bile duct biopsy is negative. Methods: Sixty two patients with strictures of the bile duct were studied prospectively. During ERCP, IDUS was performed using an ultrasonic probe (diameter 2.0 mm; frequency 20 MHz). Following IDUS, a bile duct biopsy was performed using forceps (diameter 1.8 mm). The IDUS images of the tumour were classified as polypoid lesions, localised wall thickening, intraductal sessile tumours, sessile tumour outside of the bile duct, or absence of apparent lesion. The bile duct wall structures at the site of the tumour as well as the maximum diameter of the tumour were also analysed. The IDUS findings were compared with the histological findings or clinical course. Results: When the IDUS images showed a polypoid lesion (n=19), localised wall thickening (n=8), intraductal sessile tumour (n=13), and sessile tumour outside of the bile duct (n = 20), the sensitivities of the biopsy were 80%, 50%, 92%, and 53%, respectively. Multiple regression analysis showed that the presence of sessile tumour (intraductal or outside of the bile duct: p<0.05), tumour size greater than 10.0 mm (p<0.001), and interrupted wall structure (p<0.05) were independent variables that predicted malignancy. Conclusion:When biopsy fails to demonstrate evidence of malignancy, the presence of sessile tumour (intraductal or outside of the bile duct), tumour size greater than 10.0 mm, and interrupted wall structure on IDUS images are factors that can predict malignancy.

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Section: Methodsmentioning

confidence: 99%

Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures

Tamada

Tomiyama

Wada

et al. 2002

Gut

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“…[3][4][5][6][7][8] Additionally, a dilated common duct provides information regarding treatment of choledocholithiasis and cholecystitis. An enlarged common duct is predictive of difficulties during laparascopic cholecystectomy, 9 the efficacy of endoscopic balloon sphincteroplasty, 10 and the risk of complications in endoscopic sphincterotomy. 11 Preoperative sonographic measurement of the common duct is also a factor predicting the need for preoperative endoscopic or intraoperative cholangiography.…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional Sonographic Evaluation of the Common Bile Duct

Rao

Champine

Forte³

et al. 2003

J of Ultrasound Medicine

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“…Endoscopic balloon sphincteroplasty has recently been proposed as an alternative to sphincterotomy for the treatment of bile duct stones 1–7 . Pancreatitis secondary to manipulation of the papilla of Vater is a major complication of EBS.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic balloon sphincteroplasty (papillary dilation) without endoscopic sphincterotomy (ES) has recently been reintroduced as a safe, minimally invasive, and function‐preserving method for the treatment of bile duct stones 1–7 . However, pancreatitis has been reported in 5–7% of patients after endoscopic balloon sphincteroplasty (EBS) 2–7 . This complication may be fatal 8 .…”

Section: Introductionmentioning

confidence: 99%

Epinephrine irrigation for the prevention of pancreatic damage after endoscopic balloon sphincteroplasty

Ohashi¹,

Tamada²,

Tomiyama³

et al. 2001

J of Gastro and Hepatol

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Influence of Bile Duct Diameter on the Therapeutic Quality of Endoscopic Balloon Sphincteroplasty

Abstract: When EBS is done in patients with bile duct stones, bile duct diameter may be a good indicator of therapeutic efficacy. In patients with severely dilated bile ducts (> 15 mm), EBS is of limited effectiveness.

Cited by 17 publications

References 6 publications

Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures

Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures

Three‐dimensional Sonographic Evaluation of the Common Bile Duct

Epinephrine irrigation for the prevention of pancreatic damage after endoscopic balloon sphincteroplasty

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