Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Zhao HC, He L, Zhou DC, Geng XP, Pan FM. Meta-analysis comparison of endoscopic papillary balloon dilatation and endoscopic sphincteropapillotomy. World J Gastroenterol 2013; 19(24): 3883-3891 [PMID: 23840129 DOI: 10.3748/wjg.v19.i24.3883] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] Open

For:	Zhao HC, He L, Zhou DC, Geng XP, Pan FM. Meta-analysis comparison of endoscopic papillary balloon dilatation and endoscopic sphincteropapillotomy. World J Gastroenterol 2013; 19(24): 3883-3891 [PMID: 23840129 DOI: 10.3748/wjg.v19.i24.3883] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] Open

Number

Cited by Other Article(s)

Yang Y, Zhao Z, Wu S, Yao D. Structural or functional abnormality of sphincter of Oddi: an important factor for the recurrence of choledocholithiasis after endoscopic treatment. Ann Med 2025;57:2440119. [PMID: 39673217 PMCID: PMC11648144 DOI: 10.1080/07853890.2024.2440119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/15/2024] [Accepted: 11/01/2024] [Indexed: 12/16/2024] Open

Ishida Y, Hisa T, Matsumoto R, Nishiyama S, Kudo A, Yamada T, Osera S, Tomori A, Fukushima H. Utility and safety of endoscopic papillary balloon dilation with small-incision sphincterotomy for small bile duct stones: A randomized controlled trial. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2025;32:160-167. [PMID: 39663138 DOI: 10.1002/jhbp.12097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2024]

Wongkanong C, Ratanachu-Ek T, Patumanond J. Comparative Success Rate and Adverse Effects of Endoscopic Sphincterotomy Versus Endoscopic Papillary Large Balloon Dilation in Large Common Bile Duct Stones Removal. A Propensity Scores Inverse Weighting Analysis. J Gastroenterol Hepatol 2025;40:510-519. [PMID: 39567773 DOI: 10.1111/jgh.16825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 08/01/2024] [Accepted: 11/07/2024] [Indexed: 11/22/2024]

Gao L, Yan H, Bu L, Zhang H. Endoscopic Papillary Balloon Dilation Versus Small Endoscopic Sphincterotomy for Endoscopic Retrograde Cholangiopancreatography-Related Adverse Events in Patients With Non-Dilated Distal Bile Duct. Surg Laparosc Endosc Percutan Tech 2025:00129689-990000000-00301. [PMID: 39895510 DOI: 10.1097/sle.0000000000001200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/02/2023] [Indexed: 02/04/2025]

Abstract

OBJECTIVE

Endoscopic papillary balloon dilation (EPBD), small endoscopic sphincterotomy (EST), and small EST plus EPBD are commonly used as rescue techniques to remove bile duct stones. However, we often encountered challenging cases with non-dilated distal bile ducts, especially in those undergoing EPBD. We aimed to explore the reasons by assessing whether patients without the dilated bile duct had a higher risk of early complications and whether it was impacted by the rescue techniques.

METHODS

We performed a retrospective cohort study by frequency matching design in patients diagnosed with stones in non-dilated distal bile duct who received rescue techniques from July 2016 to June 2022. Besides, patients with stones and without dilatation of the distal bile duct (DDBD) were divided into 3 subgroups according to the rescue technique received. Outcomes were compared between the subgroups.

RESULTS

The non-DDBD group was more likely to develop post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) and hyperamylasemia (HP) than the DDBD group (P < 0.05). Some cases had mild or moderate pancreatitis, but no one in either group developed severe pancreatitis. For subgroup analysis, each technique resulted in complete stone removal; the EPBD group had a higher HP rate than the other subgroups and reached statistical significance: the EPBD group versus the small EST group (P = 0.013) and the EPBD group versus the EPBD plus small EST group (P = 0.008). Although there was no statistical significance, PEP incidence in the EPBD group was 13.7% higher than in other subgroups (P > 0.05/3).

CONCLUSION

Non-DDBD patients have a higher risk for endoscopic retrograde cholangiopancreatography-related pancreatic inflammation. EPBD should be used cautiously due to the significant association with increased rates of PEP and HP. Conversely, small EST and combination therapy are suitable for non-dilated bile duct stones because of their high safety profile and efficacy.

Collapse

Kouchi K, Takenouchi A, Matsuoka A, Yabe K, Yoshizawa H, Nakata C, Fujishiro J, Sugiyama H. Case Series of Endoscopic Papillary Balloon Dilation for Children with Common Bile Duct Stones and a Review of the Literature. J Clin Med 2024;13:2251. [PMID: 38673524 PMCID: PMC11050672 DOI: 10.3390/jcm13082251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open

Abstract

Background: Endoscopic sphincterotomy (EST) has been employed for the endoscopic treatment of common bile duct stones (CBDSs) and has been reported to have a high success rate for stone removal. However, EST is associated with a risk of bleeding, perforation, and sphincter of Oddi function disruption. To avoid these risks, endoscopic papillary balloon dilation (EPBD) is an option for CBDS. Sphincter of Oddi function preservation decreases long-term biliary infection and gallstone recurrence. EPBD may have advantages in children who require a long follow up. However, there have been few reports on pediatric cases, particularly in infants. Methods: From September 2017 to December 2023, we performed EPBD for four pediatric CBDSs. The patients were aged from 5 months to 8 years, including two infants aged 5 and 6 months. Furthermore, we reviewed the stone removal rate and complications of 545 ESTs performed at high-volume centers and 13 EPBD-reported cases in children with CBDSs. Results: CBDSs of all patients who underwent EPBD in our institution were successfully removed. No bleeding or perforation was noted; pancreatitis was observed in three patients. In an analysis of 545 ESTs in children, the stone removal rate was high, ranging from 83% to 100% (mean 96%). The incidence of pancreatitis was 0-9.6% (mean 4.4%), and the grade of pancreatitis was almost mild. The bleeding frequency was 1.3-5.4% (mean 2.7%). With regards to the grade of bleeding, seven cases were mild (64%) and four were moderate (36%). Compared with adults who underwent EST, the frequencies of pancreatitis and bleeding were almost equal in children; however, in children, once bleeding occurs, it has a higher risk of leading to blood transfusion. Stone removal via EPBD in children has a 100% success rate. Pancreatitis was responsible for all complications were related; its frequency was 46% (6/13 patients, including five mild cases and one moderate case), which is higher than that of EST and adult cases who underwent EPBD. In most children with pancreatitis, pancreatic enzyme levels returned to normal within 2-3 days following EPBD, and no severe cases caused by EPBD were reported. Conclusions: CBDS removal via EPBD in children has a high success rate with very low risk of bleeding and perforation. Although pancreatitis frequently occurs, most cases are mild. Sphincter of Oddi function preservation via EPBD is expected to prevent long-term stone recurrence and biliary tract infection, and EPBD is considered to be an effective method for CBDS removal in children.

Collapse

Li YY, Miao YS, Wang CF, Yan J, Zhou XJ, Chen YX, Li GH, Zhu L. Optimal dilation duration of 10 mm diameter balloons after limited endoscopic sphincterotomy for common bile duct stones: a randomized controlled trial. Sci Rep 2024;14:971. [PMID: 38200057 PMCID: PMC10782008 DOI: 10.1038/s41598-023-50949-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open

Wang SF, Wu CH, Sung KF, Tsou YK, Lin CH, Lee CW, Lee MH, Liu NJ. The Impact of Metabolic Factors and Lipid-Lowering Drugs on Common Bile Duct Stone Recurrence after Endoscopic Sphincterotomy with Following Cholecystectomy. J Pers Med 2023;13:1490. [PMID: 37888101 PMCID: PMC10608674 DOI: 10.3390/jpm13101490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open

Abstract

BACKGROUND

Recurrent common bile duct stone after endoscopic retrograde cholangiopancreatography is an undesirable problem, even when a following cholecystectomy is carried out. Important factors are the composition and properties of stones; the most significant etiology among these is the lipid level. While numerous studies have established the association between serum lipid levels and gallstones, no study has previously reported on recurrent common bile duct stones after endoscopic sphincterotomy with following cholecystectomy.

MATERIALS AND METHODS

We retrospectively collected 2016 patients underwent endoscopic sphincterotomy from 1 January 2015 to 31 December 2017 in Linkou Chang Gung Memorial Hospital. Finally, 303 patients whose serum lipid levels had been checked following a cholecystectomy after ERCP were included for analysis. We evaluated if metabolic factors including body weight, BMI, HbA1C, serum lipid profile, and lipid-lowering drugs may impact the rate of common bile duct stone recurrence. Furthermore, we tried to find if there is any factor that may impact time to recurrence.

RESULTS

A serum HDL level ≥ 40 (p = 0.000, OR = 0.207, 95% CI = 0.114-0.376) is a protective factor, and a total cholesterol level ≥ 200 (p = 0.004, OR = 4.558, 95% CI = 1.625-12.787) is a risk factor of recurrent common bile duct stones after endoscopic sphincterotomy with cholecystectomy. Lipid-lowering drugs, specifically statins, have been shown to reduce the risk of recurrence significantly (p = 0.003, OR = 0.297, 95% CI = 0.132-0.665). No factors were found to impact the time to recurrence in this study.

CONCLUSIONS

The serum lipid level could influence the recurrence of common bile duct stones after endoscopic sphincterotomy followed by cholecystectomy, and it appears that statins can reduce the risk of recurrence.

Collapse

Affiliation(s)

Sheng-Fu Wang Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333423, Taiwan; (C.-H.W.); (K.-F.S.); (Y.-K.T.); (C.-H.L.); (M.-H.L.); (N.-J.L.) School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333323, Taiwan;
Chi-Huan Wu Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333423, Taiwan; (C.-H.W.); (K.-F.S.); (Y.-K.T.); (C.-H.L.); (M.-H.L.); (N.-J.L.) School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333323, Taiwan;
Kai-Feng Sung Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333423, Taiwan; (C.-H.W.); (K.-F.S.); (Y.-K.T.); (C.-H.L.); (M.-H.L.); (N.-J.L.) School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333323, Taiwan;
Yung-Kuan Tsou Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333423, Taiwan; (C.-H.W.); (K.-F.S.); (Y.-K.T.); (C.-H.L.); (M.-H.L.); (N.-J.L.) School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333323, Taiwan;
Cheng-Hui Lin Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333423, Taiwan; (C.-H.W.); (K.-F.S.); (Y.-K.T.); (C.-H.L.); (M.-H.L.); (N.-J.L.) School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333323, Taiwan;
Chao-Wei Lee School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333323, Taiwan; Division of General Surgery, Department of Surgery, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333423, Taiwan
Mu-Hsien Lee Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333423, Taiwan; (C.-H.W.); (K.-F.S.); (Y.-K.T.); (C.-H.L.); (M.-H.L.); (N.-J.L.) School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333323, Taiwan;
Nai-Jen Liu Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333423, Taiwan; (C.-H.W.); (K.-F.S.); (Y.-K.T.); (C.-H.L.); (M.-H.L.); (N.-J.L.) School of Medicine, College of Medicine, Chang-Gung University, Taoyuan 333323, Taiwan;

Collapse

Fujita N, Yasuda I, Endo I, Isayama H, Iwashita T, Ueki T, Uemura K, Umezawa A, Katanuma A, Katayose Y, Suzuki Y, Shoda J, Tsuyuguchi T, Wakai T, Inui K, Unno M, Takeyama Y, Itoi T, Koike K, Mochida S. Evidence-based clinical practice guidelines for cholelithiasis 2021. J Gastroenterol 2023;58:801-833. [PMID: 37452855 PMCID: PMC10423145 DOI: 10.1007/s00535-023-02014-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]

Affiliation(s)

Naotaka Fujita Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan. Miyagi Medical Check-up Plaza, 1-6-9 Oroshi-machi, Wakabayashi-ku, Sendai, Miyagi, 984-0015, Japan.
Ichiro Yasuda Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Itaru Endo Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Hiroyuki Isayama Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Takuji Iwashita Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Toshiharu Ueki Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Kenichiro Uemura Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Akiko Umezawa Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Akio Katanuma Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Yu Katayose Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Yutaka Suzuki Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Junichi Shoda Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Toshio Tsuyuguchi Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Toshifumi Wakai Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Kazuo Inui Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Michiaki Unno Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Yoshifumi Takeyama Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Takao Itoi Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Kazuhiko Koike Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan
Satoshi Mochida Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan

Collapse

Masuda S, Koizumi K, Shionoya K, Jinushi R, Makazu M, Nishino T, Kimura K, Sumida C, Kubota J, Ichita C, Sasaki A, Kobayashi M, Kako M, Haruki U. Comprehensive review on small common bile duct stones. World J Gastroenterol 2023;29:1955-1968. [PMID: 37155530 PMCID: PMC10122794 DOI: 10.3748/wjg.v29.i13.1955] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/22/2023] [Accepted: 03/20/2023] [Indexed: 04/06/2023] Open

Wongkanong C, Patumanond J, Ratanachu-ek T, Junrungsee S, Tantraworasin A. Development of clinical prediction rule for the requirement of endoscopic papillary large balloon dilation (EPLBD) on endoscopic CBD stone clearance. PLoS One 2023;18:e0282899. [PMID: 36928213 PMCID: PMC10019717 DOI: 10.1371/journal.pone.0282899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/25/2023] [Indexed: 03/18/2023] Open

Abstract

INTRODUCTION

To develop a simplified scoring system for clinical prediction of difficulty in CBD stone removal to assist endoscopists working in resource-limited settings in deciding whether to proceed with an intervention or refer patients to a center capable of performing additional procedures and interventions.

METHODS

This study included patients with CBD stones who underwent ERCP at Pattani Hospital between August 2017 and December 2021. Retrospective cohort data was collected and patients were categorized into two groups: bile duct stones successfully treated by endoscopic biliary sphincterotomy and extraction compared to the former method combined with EPLBD. We explored potential predictors using multivariable logistic regression. The chosen logistic coefficients were transformed into a scoring system based on risk with internal validation via bootstrapping procedure.

RESULTS

Among the 155 patients who had successful endoscopic therapy for bile duct stones, there were 79 (50.97%) cases of endoscopic biliary sphincterotomy, EPLBD and extraction versus 76 (49.03%) cases without EPLBD. The factors used to derive a scoring system included the size of CBD stones >15 mm, the difference between the stone and distal CBD diameter >2mm, distal CBD arm length <36 mm and stone shape. The score-based model's area under ROC was 0.88 (95% CI: 0.83, 0.93). For clinical use, the range of scores from 0 to 16, was divided into two subcategories based on CBD stone removal difficulty requiring EPLBD to derive the PPV. For scores <5 and ≥ 5, the PPV was 23.40 (p <0.001) and 93.44 (p <0.001) respectively. The Bootstrap sampling method indicated a prediction ability of 0.88 (AuROC, 95% CI: 0.83, 0.94).

CONCLUSION

This scoring system has acceptable prediction performance in assisting endoscopists in their choice of stone removal procedure.

Collapse

Wongkanong C, Patumanond J, Ratanachu‐ek T, Junrungsee S, Tantraworasin A. Common bile duct stone-related parameters and their potential prognostic values for stone extraction requiring endoscopic papillary large balloon dilation. JGH Open 2022;7:16-23. [PMID: 36660050 PMCID: PMC9840188 DOI: 10.1002/jgh3.12845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/16/2022] [Accepted: 11/06/2022] [Indexed: 11/25/2022]

Predictors for stone recurrence after a successful common bile duct surgical exploration for choledocholithiasis. Langenbecks Arch Surg 2022;407:1545-1552. [PMID: 35670858 DOI: 10.1007/s00423-022-02577-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/30/2022] [Indexed: 10/18/2022]

Ji X, Yang Z, Ma SR, Jia W, Zhao Q, Xu L, Kan Y, Cao Y, Wang Y, Fan BJ. New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence. World J Gastrointest Surg 2022;14:236-246. [PMID: 35432763 PMCID: PMC8984516 DOI: 10.4240/wjgs.v14.i3.236] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/12/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open

Williams EJ, Krishnan B, Lau SY. Difficult Biliary Cannulation and Sphincterotomy: What to Do. GASTROINTESTINAL AND PANCREATICO-BILIARY DISEASES: ADVANCED DIAGNOSTIC AND THERAPEUTIC ENDOSCOPY 2022:1121-1153. [DOI: 10.1007/978-3-030-56993-8_65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2025]

Ji X, Jia W, Zhao Q, Wang Y, Ma SR, Xu L, Kan Y, Cao Y, Fan BJ, Yang Z. Common bile duct morphology is associated with recurrence of common bile duct stones in Billroth II anatomy patients. World J Clin Cases 2021;9:7671-7681. [PMID: 34621818 PMCID: PMC8462226 DOI: 10.12998/wjcc.v9.i26.7671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/20/2021] [Accepted: 07/29/2021] [Indexed: 02/06/2023] Open

Affiliation(s)

Xu Ji Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China Postgraduate College, Dalian Medical University, Dalian 116044, Liaoning Province, China
Wen Jia Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
Qian Zhao Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China Postgraduate College, Dalian Medical University, Dalian 116044, Liaoning Province, China
Yao Wang Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China Postgraduate College, Liaoning University of Traditional Chinese Medicine, Shenyang 110847, Liaoning Province, China
Shu-Ren Ma Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
Lu Xu Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China Postgraduate College, Dalian Medical University, Dalian 116044, Liaoning Province, China
Ying Kan Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China Postgraduate College, Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China
Yang Cao Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China Postgraduate College, Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China
Bao-Jun Fan Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China Postgraduate College, Liaoning University of Traditional Chinese Medicine, Shenyang 110847, Liaoning Province, China
Zhuo Yang Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China

Collapse

Kamada T, Ohdaira H, Takeuchi H, Takahashi J, Marukuchi R, Ito E, Suzuki N, Narihiro S, Hoshimoto S, Yoshida M, Yamanouchi E, Suzuki Y. One-stage fluoroscopy-guided laparoscopic transcystic papillary balloon dilation and laparoscopic cholecystectomy in patients with cholecystocholedocholithiasis who previously had undergone gastrectomy for gastric cancer. Asian J Endosc Surg 2021;14:193-199. [PMID: 32790037 PMCID: PMC8048915 DOI: 10.1111/ases.12845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/23/2022]

Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety. J Clin Med 2020;9:jcm9123808. [PMID: 33255554 PMCID: PMC7760048 DOI: 10.3390/jcm9123808] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 12/22/2022] Open

Ishii S, Fujisawa T, Ushio M, Takahashi S, Yamagata W, Takasaki Y, Suzuki A, Okawa Y, Ochiai K, Tomishima K, Kanazawa R, Saito H, Shiina S, Isayama H. Evaluation of the safety and efficacy of minimal endoscopic sphincterotomy followed by papillary balloon dilation for the removal of common bile duct stones. Saudi J Gastroenterol 2020;26:290342. [PMID: 32719239 PMCID: PMC8019135 DOI: 10.4103/sjg.sjg_162_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/03/2020] [Accepted: 06/14/2020] [Indexed: 12/12/2022] Open

Maida M, Sferrazza S, Maida C, Morreale GC, Vitello A, Longo G, Garofalo V, Sinagra E. Management of antiplatelet or anticoagulant therapy in endoscopy: A review of literature. World J Gastrointest Endosc 2020;12:172-192. [PMID: 32843928 PMCID: PMC7415229 DOI: 10.4253/wjge.v12.i6.172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/09/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023] Open

Shinoura S, Tokushige A, Chinen K, Mori H, Kato S, Ueda S. Association between contrast-induced nephrotoxicity and contrast enhanced computed tomography followed by endoscopic retrograde cholangiopancreatography. Eur J Radiol 2020;129:109074. [PMID: 32473539 DOI: 10.1016/j.ejrad.2020.109074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 11/19/2022]

Chou CK, Lee KC, Luo JC, Chen TS, Perng CL, Huang YH, Lin HC, Hou MC. Endoscopic papillary balloon dilatation less than three minutes for biliary stone removal increases the risk of post-ERCP pancreatitis. PLoS One 2020;15:e0233388. [PMID: 32453738 PMCID: PMC7250446 DOI: 10.1371/journal.pone.0233388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 05/04/2020] [Indexed: 01/22/2023] Open

Affiliation(s)

Chung-Kai Chou Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans’ General Hospital, Taipei, Taiwan Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan Division of Gastroenterology, Department of Medicine, National Yang-Ming University Hospital, Ilan, Taiwan
Kuei-Chuan Lee Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans’ General Hospital, Taipei, Taiwan Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan * E-mail: (KCL); (JCL)
Jiing-Chyuan Luo Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans’ General Hospital, Taipei, Taiwan Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan * E-mail: (KCL); (JCL)
Tseng-Shing Chen Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans’ General Hospital, Taipei, Taiwan Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
Chin-Lin Perng Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans’ General Hospital, Taipei, Taiwan Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
Yi-Hsiang Huang Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans’ General Hospital, Taipei, Taiwan Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
Han-Chien Lin Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans’ General Hospital, Taipei, Taiwan Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
Ming-Chih Hou Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans’ General Hospital, Taipei, Taiwan Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan

Collapse

Li JS, Zou DW, Jin ZD, Chen J, Shi XG, Li ZS, Liu F. Endoscopic retrograde cholangiopancreatography in Billroth II gastrectomy patients: Outcomes and potential factors affecting technical failure. Saudi J Gastroenterol 2019;25:355-361. [PMID: 31187782 PMCID: PMC6941460 DOI: 10.4103/sjg.sjg_118_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open

Sugimoto M, Takagi T, Suzuki R, Konno N, Asama H, Sato Y, Irie H, Watanabe K, Nakamura J, Kikuchi H, Takasumi M, Hashimoto M, Hikichi T, Ohira H. Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis using pancreatic stents: A review of efficacy, diameter and length. World J Meta-Anal 2019;7:259-268. [DOI: 10.13105/wjma.v7.i6.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/02/2019] [Accepted: 06/10/2019] [Indexed: 02/06/2023] Open

Affiliation(s)

Mitsuru Sugimoto Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan
Tadayuki Takagi Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan
Rei Suzuki Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan
Naoki Konno Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan
Hiroyuki Asama Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan
Yuki Sato Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan
Hiroki Irie Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan
Ko Watanabe Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 9601295, Japan
Jun Nakamura Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 9601295, Japan
Hitomi Kikuchi Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 9601295, Japan
Mika Takasumi Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan
Minami Hashimoto Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 9601295, Japan
Takuto Hikichi Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 9601295, Japan
Hiromasa Ohira Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan

Collapse

Meng W, Leung JW, Zhang K, Zhou W, Wang Z, Zhang L, Sun H, Xue P, Liu W, Wang Q, Zhang J, Wang X, Wang M, Shao Y, Cai K, Hou S, Li Q, Zhang L, Zhu K, Yue P, Wang H, Zhang M, Sun X, Yang Z, Tao J, Wen Z, Wang Q, Chen B, Shao Q, Zhao M, Zhang R, Jiang T, Liu K, Zhang L, Chen K, Zhu X, Zhang H, Miao L, Wang Z, Li J, Yan X, Wang F, Zhang L, Suzuki A, Tanaka K, Nur U, Weiderpass E, Li X. Optimal dilation time for combined small endoscopic sphincterotomy and balloon dilation for common bile duct stones: a multicentre, single-blinded, randomised controlled trial. Lancet Gastroenterol Hepatol 2019;4:425-434. [PMID: 31003961 DOI: 10.1016/s2468-1253(19)30075-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/22/2019] [Accepted: 02/23/2019] [Indexed: 12/19/2022]

Abstract

BACKGROUND

Endoscopic sphincterotomy is the established treatment for common bile duct stones. Balloon dilation offers an alternative. Prolonged dilation (300 s) with a 10 mm diameter balloon decreases the occurrence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). We aimed to determine the optimal duration of dilation for combined endoscopic sphincterotomy and balloon dilation for the removal of common bile duct stones.

METHODS

We did a multicentre, single-blinded, randomised controlled trial at 15 tertiary surgical centres in China. Eligible patients (≥18 years) with native papilla and common bile duct stones (≤1·5 cm in size and <2 cm in diameter) undergoing ERCP were randomly assigned (1:1:1:1:1) to receive balloon dilation for 0, 30, 60, 180, or 300 s after deep bile duct cannulation. Randomisation was done by an independent statistician using a computer-generated randomisation list with a block size of ten, stratified by centre. Patients and outcome assessors, but not endoscopists and investigators, were masked to treatment allocation. Balloon dilation was done with controlled radial expansion balloons according to common bile duct stone size. Stones were removed using stone retrieval balloons or baskets. The primary endpoint was overall frequency of post-ERCP pancreatitis. The primary efficacy analysis and safety analyses were done in the modified intention-to-treat population, which included all randomly assigned patients with successful cannulation, but excluded those who withdrew consent after randomisation. This study was registered with ClinicalTrials.gov, number NCT02510495, and is complete.

FINDINGS

Between July 29, 2015, and Dec 1, 2017, 3721 consecutive patients with common bile duct stones were recruited, 1718 of whom were excluded. The remaining 2003 patients underwent a small (3-5 mm) endoscopic sphincterotomy. 83 patients withdrew consent after the ERCP procedure, thus 1920 patients were included in the modified intention-to-treat analysis (0 s [n=371], 30 s [n=384], 60 s [n=388], 180 s [n=390], and 300 s [n=387]). Overall, post-ERCP pancreatitis occurred in 199 (10%) of 1920 patients (44 [12%] patients in the 0 s group, 28 [7%] in the 30 s group, 32 [8%] in the 60 s group, 36 [9%] in the 180 s group, and 59 [15%] in the 300 s group). Prolonged dilation (300 s) significantly increased the occurrence of post-ERCP pancreatitis compared with shorter balloon dilation (p=0·002). The frequency of post-ERCP pancreatitis was significantly lower in the 30, 60, and 180 s groups than in the 300 s group (relative risk [RR] 0·48, 95% CI 0·31-0·73; p=0·0005 vs the 30 s group; 0·54, 0·36-0·81; p=0·003 vs the 60 s group; 0·61, 0·41-0·89; p=0·01 vs the 180 s group). The frequency of post-ERCP pancreatitis was significantly higher in the 0 s group than the 30 s group (RR 1·62, 1·04-2·56; p=0·03). No difference in stone extraction (all ≥90%) was observed between groups. Following ERCP, 90 (5%) of 1920 patients had acute cholangitis, 14 (<1%) had acute cholecystitis, and five (<1%) had gastrointestinal bleeding, with no significant differences between groups. One (<1%) patient had Stapfer II perforation, which resolved spontaneously with conservative treatment.

INTERPRETATION

A balloon dilation time of 30 s for combined endoscopic sphincterotomy and balloon dilation reduced the frequency of post-ERCP pancreatitis and was determined to be the optimum dilation time for the removal of common bile duct stones.

FUNDING

National Natural Science Foundation of China, Gansu Competitive Foundation Projects for Technology Development and Innovation.

Collapse

Affiliation(s)

Wenbo Meng Department of Special Minimally Invasive Surgery, CHESS Center, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Joseph W Leung Division of Gastroenterology and Hepatology, University of California, Davis Medical Center and Sacramento Veterans Affairs Medical Center, Sacramento, CA, USA
Kai Zhang Hepatobiliary Surgery Department, Shandong Provincial Third Hospital, Jinan, China
Wence Zhou Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Zhenyu Wang Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Leida Zhang Department of Hepatobiliary Surgery, Southwest Hospital, Army Medical University, Chongqing, China
Hao Sun Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
Ping Xue Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
Wei Liu Minimal Invasive Surgery Centre, Second Xiangya Hospital, Central South University, Changsha, China
Qi Wang Minimal Invasive Surgery Centre, Second Xiangya Hospital, Central South University, Changsha, China; Department of Hepatobiliary Surgery, The General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
Jijun Zhang Department of General Surgery, Sixth Hospital of Shanxi Medical University (General Hospital of TISCO), Taiyuan, China
Xuefeng Wang Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
Meng Wang Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, China
Yingmei Shao Department of Hepatobiliary and Hydatid, Digestive and Vascular Surgery Centre, Xinjiang Key Laboratory of Echinococcosis and Liver Surgery Research, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
Kailin Cai Gastrointestinal Surgery Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Senlin Hou Department of Biliopancreatic Endoscopic Surgery, Second Hospital of Hebei Medical University, Shijiazhuang, China
Qiyong Li Division of Hepatobiliary and Pancreatic Surgery, School of Medicine, Shulan (Hangzhou) Hospital, Zhejiang University, Hangzhou, China
Lei Zhang Fifth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Kexiang Zhu Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Ping Yue Department of Special Minimally Invasive Surgery, CHESS Center, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Haiping Wang Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Ming Zhang Hepatobiliary Surgery Department, Shandong Provincial Third Hospital, Jinan, China
Xiangyu Sun Centre of Minimally Invasive Surgery, Tianjin Nankai Hospital, Tianjin, China
Zhiqing Yang Department of Hepatobiliary Surgery, Southwest Hospital, Army Medical University, Chongqing, China
Jie Tao Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
Zilong Wen Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
Qunwei Wang Minimal Invasive Surgery Centre, Second Xiangya Hospital, Central South University, Changsha, China; Department of Hepatobiliary Surgery, The General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
Bendong Chen Department of Hepatobiliary Surgery, The General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
Quan Shao Department of General Surgery, Sixth Hospital of Shanxi Medical University (General Hospital of TISCO), Taiyuan, China
Mingning Zhao Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
Ruoyan Zhang Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, China
Tiemin Jiang Department of Hepatobiliary and Hydatid, Digestive and Vascular Surgery Centre, Xinjiang Key Laboratory of Echinococcosis and Liver Surgery Research, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
Ke Liu Gastrointestinal Surgery Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Lichao Zhang Department of Biliopancreatic Endoscopic Surgery, Second Hospital of Hebei Medical University, Shijiazhuang, China
Kangjie Chen Division of Hepatobiliary and Pancreatic Surgery, School of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
Xiaoliang Zhu Fifth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Hui Zhang Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Long Miao Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Zhengfeng Wang Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Jiajia Li Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Xiaowen Yan Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China
Fangzhao Wang Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China
Lingen Zhang Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China
Azumi Suzuki Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan
Kiyohito Tanaka Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan
Ula Nur Department of Public Health, College of Health Sciences, Qatar University Health, Qatar University, Doha, Qatar
Elisabete Weiderpass International Agency for Research on Cancer, Lyon, France
Xun Li Fifth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, Lanzhou, China; Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province, Lanzhou, China.

Collapse

Sugimoto M, Takagi T, Suzuki R, Konno N, Asama H, Sato Y, Irie H, Watanabe K, Nakamura J, Kikuchi H, Takasumi M, Hashimoto M, Hikichi T, Ohira H. Pancreatic stents to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis: A meta-analysis. World J Meta-Anal 2019;7:249-258. [DOI: 10.13105/wjma.v7.i5.249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/07/2019] [Accepted: 05/11/2019] [Indexed: 02/06/2023] Open

Abstract

BACKGROUND

Endoscopic retrograde cholangiopancreatography (ERCP) plays a major role in the investigation and treatment of pancreaticobiliary diseases. However, post-ERCP pancreatitis (PEP) is a severe adverse effect. Prior meta-analyses have shown that prophylactic PS was useful for preventing PEP. However, abstract reports and patients who underwent endoscopic ampullectomy were included in the previous analyses. In addition, two meta-analyses involved non-randomized controlled trials (RCTs). The efficacy of PS for preventing severe PEP was different in each meta-analysis. Therefore, we performed the current meta-analysis, which included only full-text articles, and added new findings.

AIM

To reveal the efficacy of prophylactic pancreatic stent (PS) placement for preventing PEP.

METHODS

We searched the MEDLINE, Cochrane Library and PubMed databases for related RCTs. Among the reports retrieved, 11 studies were included in this meta-analysis. All full-text articles were published between 1993 and 2016. A total of 1475 patients were enrolled in the included studies; of these patients, 734 had a PS inserted, and 741 did not have a PS inserted. PEP and severe PEP occurrence were evaluated in this meta-analysis.

RESULTS

PEP was observed in all studies and occurred in 39 (5.3%) patients who received a PS. On the other hand, PEP occurred in 141 (19%) patients who did not receive a PS. The occurrence of PEP was significantly lower in the patients who underwent PS placement than in the patients who did not receive a PS (OR = 0.32; 95%CI: 0.23-0.45; P < 0.001). In addition, the occurrence of severe PEP was evaluated. Notably, the occurrence of severe PEP was not observed in the stent group; however, the occurrence of severe PEP was observed in 8 (1.3%) patients who did not have a PS inserted. Severe PEP occurred significantly less often in the stent group than in the no stent group (OR = 0.24; 95%CI: 0.06-0.94; P = 0.04).

CONCLUSION

In conclusion, prophylactic PS placement is useful for preventing PEP and severe PEP.

Collapse

Affiliation(s)

Mitsuru Sugimoto Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan
Tadayuki Takagi Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan
Rei Suzuki Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan
Naoki Konno Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan
Hiroyuki Asama Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan
Yuki Sato Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan
Hiroki Irie Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan
Ko Watanabe Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City, Fukushima Prefecture 960-1295, Japan
Jun Nakamura Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City, Fukushima Prefecture 960-1295, Japan
Hitomi Kikuchi Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City, Fukushima Prefecture 960-1295, Japan
Mika Takasumi Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan
Minami Hashimoto Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City, Fukushima Prefecture 960-1295, Japan
Takuto Hikichi Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City, Fukushima Prefecture 960-1295, Japan
Hiromasa Ohira Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan

Collapse

Dilation after small biliary sphincterotomy. Lancet Gastroenterol Hepatol 2019;4:414-415. [PMID: 31003962 DOI: 10.1016/s2468-1253(19)30121-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 11/23/2022]

Haseeb A, Freeman ML. Endoscopic Papillary Large Balloon Dilation Versus Endoscopic Sphincterotomy for Treatment of Bile Duct Stones. ACTA ACUST UNITED AC 2019;17:221-230. [PMID: 30945095 DOI: 10.1007/s11938-019-00234-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]

Tsai MC, Wang CC, Wang YT, Yang TW, Chen HY, Tseng MH, Lin CC. Major bleeding risk of endoscopic sphincterotomy versus endoscopic papillary balloon dilatation in hemodialysis patients. Saudi J Gastroenterol 2019;25:106-112. [PMID: 30479319 PMCID: PMC6457181 DOI: 10.4103/sjg.sjg_246_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open

Abstract

BACKGROUND/AIMS

Endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilatation (EPBD) are used for therapeutic endoscopic retrograde cholangiopancreatography (ERCP). The postprocedure bleeding rate for EPBD is low in the normal population; however, this bleeding rate in a group of patients prone to bleeding, such as patients with end-stage renal disease, is not well-established. We therefore evaluated the post-EST and post-EPBD bleeding rate among hemodialysis (HD) patients based on data from Taiwan's National Health Insurance Research Database (NHIRD).

PATIENTS AND METHODS

The NHIRD entries for a population of 2 million were screened for patients who had a catastrophic illness card for HD between 1^st January 2004 and 31^st December 2011 and these patients were enrolled as research subjects. The rates of major gastrointestinal tract bleeding events appearing within 14 days after EST or EPBD were compared between HD and non-HD patients.

RESULTS

A total of 3561 patients, over 18 years of age and without liver cirrhosis or hematologic diseases, underwent 3826 EST and 280 EPBD procedures during the 8 calendar years selected for our analysis. The total post-ERCP major bleeding rate was much higher in HD than in non-HD patients (8.64% vs. 2.16%, P < 0.0001). The rate of postprocedure major bleeding events was lower for non-HD patients who underwent EPBD than those who underwent EST (0.75% vs. 2.26%; P = 0.049), whereas the postprocedure major bleeding event rates were similar in HD patients who underwent either EPBD or EST (8.70% vs. 8.33%; P = 0.484).

CONCLUSION

Post-ERCP, post-EST, and post-EPBD major bleeding rates were all higher in HD patients in this study. EPBD resulted in lower postprocedure major bleeding events than EST in the non-HD population, but it failed to provide the reduction in bleeding events needed to perform endoscopic hemostasis in HD patients.

Collapse

Affiliation(s)

Ming-Chang Tsai Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan,2School of Medicine, Chung Shan Medical University, Taichung, Taiwan,3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
Chi-Chih Wang Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan,2School of Medicine, Chung Shan Medical University, Taichung, Taiwan,3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
Yao-Tung Wang Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan,2School of Medicine, Chung Shan Medical University, Taichung, Taiwan,4Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
Tzu-Wei Yang Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan,5Department of Biological Science and Technology, Institute of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
Hsuan-Yi Chen School of Medicine, Chung Shan Medical University, Taichung, Taiwan,3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
Ming-Hseng Tseng Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan,7Information Technology Office, Chung Shan Medical University Hospital, Taichung, Taiwan,Address for correspondence: Prof. Chun-Che Lin, School of Medicine, Chung Shan Medical University, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South Dist., Taichung City 402, Taiwan. E-mail: Prof. Ming-Hseng Tseng, Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan. E-mail:
Chun-Che Lin Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan,2School of Medicine, Chung Shan Medical University, Taichung, Taiwan,3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan,Address for correspondence: Prof. Chun-Che Lin, School of Medicine, Chung Shan Medical University, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South Dist., Taichung City 402, Taiwan. E-mail: Prof. Ming-Hseng Tseng, Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan. E-mail:

Collapse

Köksal AŞ, Eminler AT, Parlak E. Biliary endoscopic sphincterotomy: Techniques and complications. World J Clin Cases 2018;6:1073-1086. [PMID: 30613665 PMCID: PMC6306628 DOI: 10.12998/wjcc.v6.i16.1073] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/20/2018] [Accepted: 11/26/2018] [Indexed: 02/05/2023] Open

Naitoh I, Hori Y. Post-ERCP Complications in Dialysis Patients: Cutting One's Losses or Expanding Possibilities? Dig Dis Sci 2018;63:2826-2828. [PMID: 29934722 DOI: 10.1007/s10620-018-5173-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]

Aujla UI, Ladep N, Dwyer L, Hood S, Stern N, Sturgess R. Endoscopic papillary large balloon dilatation with sphincterotomy is safe and effective for biliary stone removal independent of timing and size of sphincterotomy. World J Gastroenterol 2017;23:8597-8604. [PMID: 29358868 PMCID: PMC5752720 DOI: 10.3748/wjg.v23.i48.8597] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/31/2017] [Accepted: 11/14/2017] [Indexed: 02/06/2023] Open

Abstract

AIM

To describe the efficacy and safety of endoscopic papillary large balloon dilatation (EPLBD) in the management of bile duct stones in a Western population.

METHODS

Data 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 1^st August 2009 to 31^st 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.

RESULTS

EPLBD 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 (1^st 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.

CONCLUSION

EPLBD 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.

Collapse

Alberca de Las Parras F, Egea Valenzuela J, Carballo Álvarez F. Bleeding risk in endoscopic retrograde cholangiopancreatography. Impact of the use of antithrombotic drugs. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2017;109:202-210. [PMID: 28112960 DOI: 10.17235/reed.2017.4358/2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]

Kuo YT, Wang HP, Chang CY, Leung JW, Chen JH, Tsai MC, Liao WC. Comparable Long-term Outcomes of 1-Minute vs 5-Minute Endoscopic Papillary Balloon Dilation for Bile Duct Stones. Clin Gastroenterol Hepatol 2017;15:1768-1775. [PMID: 28603054 DOI: 10.1016/j.cgh.2017.05.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/24/2017] [Accepted: 05/26/2017] [Indexed: 02/07/2023]

Abstract

BACKGROUND & AIMS

Endoscopic papillary balloon dilation (EPBD) is an alternative to endoscopic sphincterotomy for choledocholithiasis. Unlike endoscopic sphincterotomy, EPBD preserves biliary sphincter function, reducing long-term risk of recurrent choledocholithiasis by 50%. Guidelines recommend that duration of EPBD exceeds 2 minutes, to adequately loosen the sphincter and reduce risks of failed stone extraction and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, it is unclear whether this long duration of EPBD impairs sphincter function and negates the long-term benefit of EPBD. We performed a randomized controlled trial to determine whether long-duration (>1 minute) EPBD increases the risk of subsequent choledocholithiasis and hepatobiliary complications compared with short-duration EPBD (<1 minute).

METHODS

We performed a prospective study of 170 adult patients who underwent ERCP for suspected choledocholithiasis from April 2007 through October 2008 at 2 centers in Taiwan. Patients were randomly assigned to groups that underwent 1-minute (n = 86) or 5-minute (n = 84) EPBD for choledocholithiasis; patients were followed through June 2015. One month after the initial ERCP, patients were examined and liver function tests and abdominal sonographies were performed. Patients were then examined every 3-6 months over a median follow-up period of approximately 7 years. The primary outcome was recurrent choledocholithiasis or acute cholangitis and the secondary outcome was overall hepatobiliary complications. We assessed the effects of EPBD duration by Cox regression.

RESULTS

Thirteen patients (15.1%) developed recurrent choledocholithiasis or acute cholangitis after 1-minute EPBD, and 10 patients (11.9%) developed recurrent choledocholithiasis or acute cholangitis after 5-minute EPBD (P = .352). There was no significant difference between groups in number of hepatobiliary complications (P = .154). Compared with 1-minute EPBD, 5-minute EPBD did not increase risk of the primary outcome (adjusted hazard ratio, 0.76; 95% confidence interval, 0.32-1.82) or the secondary outcome (adjusted hazard ratio, 0.65; 95% confidence interval, 0.31-1.40). Mechanical lithotripsy, performed for failed stone extraction with EPBD at initial ERCP, was a risk factor for primary and secondary outcomes.

CONCLUSIONS

In a randomized controlled trial, we found that the risk of recurrent choledocholithiasis and hepatobiliary complications did not increase with long-duration EPBD (>1 minute), but was increased with mechanical lithotripsy.

Collapse

Cho E, Park CH, Jun CH, Kim HS, Choi SK, Rew JS. Self-expandable metal stents for the extraction of common bile duct stones in patients receiving dual antiplatelet agents: a pilot study. Surg Endosc 2017;32:1077-1081. [PMID: 28733742 DOI: 10.1007/s00464-017-5743-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 07/14/2017] [Indexed: 12/28/2022]

Omar MA, Abdelshafy M, Ahmed MY, Rezk AG, Taha AM, Hussein HM. Endoscopic Papillary Large Balloon Dilation Versus Endoscopic Sphincterotomy for Retrieval of Large Choledocholithiasis: A Prospective Randomized Trial. J Laparoendosc Adv Surg Tech A 2017;27:704-709. [DOI: 10.1089/lap.2016.0601] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open

Endoscopy in Patients on Antiplatelet Agents and Anticoagulants. ACTA ACUST UNITED AC 2017;15:256-267. [PMID: 28540489 DOI: 10.1007/s11938-017-0137-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]

Abstract

OPINION STATEMENT

Management of patients on anticoagulant or antiplatelet therapy undergoing endoscopy presents a balance of risks between haemorrhage due to the procedure, and thrombosis due to discontinuation of antithrombotic therapy. Haemorrhage is usually controllable endoscopically, but thrombosis could, on occasion, result in myocardial infarction or stroke, with permanent disability or death. For elective procedures, there is adequate time to plan best management of antithrombotic therapy. International guidelines have been published, but recommendations are based on limited evidence and consultation with appropriate medical specialists, and the patient is important. Patients on dual antiplatelet therapy for coronary stents are at particularly high risk of thrombosis if therapy is interrupted. Direct oral anticoagulants have been a great advance in the management of anticoagulation but can present an increased risk of spontaneous gastrointestinal haemorrhage, as well as a difficult management situation in haemorrhage following endoscopic therapy. For elective endoscopic procedures, there may be a suitable alternative investigation, and some patients can have therapy deferred if high-risk antithrombotic therapy is temporary. Gastrointestinal haemorrhage on antithrombotic therapy can present a life-threatening situation from potential thrombosis as well as haemorrhage. Management is particularly challenging on direct oral anticoagulants (DOACs), but a reversal agent is available for dabigatran, and others are in development. The safest time to restart antithrombotic therapy after therapeutic procedures or haemorrhage has been little studied, and the relevant risk factors are discussed together with advice on management. Although guidelines have been produced, there remains much uncertainty in the management of antithrombotic therapy for endoscopy, particularly for newer agents, and further research is required.

Collapse

Williams E, Beckingham I, El Sayed G, Gurusamy K, Sturgess R, Webster G, Young T. Updated guideline on the management of common bile duct stones (CBDS). Gut 2017;66:765-782. [PMID: 28122906 DOI: 10.1136/gutjnl-2016-312317] [Citation(s) in RCA: 244] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 12/08/2016] [Accepted: 12/15/2016] [Indexed: 02/06/2023]

Mok SRS, Arif M, Diehl DL, Khara HS, Ho HC, Elfant AB. Safety and efficacy of minimal biliary sphincterotomy with papillary balloon dilation (m-EBS+EPBD) in patients using clopidogrel or anticoagulation. Endosc Int Open 2017;5:E157-E164. [PMID: 28337485 PMCID: PMC5361880 DOI: 10.1055/s-0042-120225] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open

Abstract

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (EBS) or endoscopic papillary balloon dilation (EPBD) are common techniques of biliary decompression. Potential risks include gastrointestinal hemorrhage, which can be increased by antiplatelet agents, anticoagulants (AC) and/or novel oral anticoagulants (NOACs) (ie. apixaban, dabigatran and rivaroxaban). The study aim is to evaluate the safety/efficacy of an alternative technique, minimal-EBS plus EPBD (m-EBS + EPBD), in individuals for whom clopidogrel, AC, and/or NOACs cannot be interrupted due to high cardiovascular or thromboembolic risk. Patients and methods Patients undergoing m-EBS + EPBD while taking clopidogrel and/or AC were retrospectively evaluated at two United States tertiary care centers for efficacy, GIB and procedure-related, cardiovascular and thromboembolic adverse events (AE). Results Ninety-five patients were identified [55 = clopidogrel and 45 = AC (31.1 % NOACs)]. The main indication for ERCP was choledocholithiasis (34 %). 100 % clinical improvement and 97.9 % endoscopic success were found. The incidence of AE was 5.3 %. There was a 4.2 % incidence of gastrointestinal hemorrhage (2 cases requiring endoscopic intervention). Both severe gastrointestinal hemorrhages also experienced the cases of post-ERCP pancreatitis, and 2 /3 of cholangitis (all aspirin + AC). There was 1cardiovascular event (non-ST elevation myocardial infarction), and no thromboembolic events. Conclusions Minimal-EBS + EPBD is an effective and safe therapy with an incidence of gastrointestinal hemorrhage of 4.2 %, (2.1 % requiring endoscopic intervention), for patients on clopidogrel and/or AC, with a high risk for cardiovascular/thromboembolic events.

Collapse

Liu D, Cao F, Liu J, Xu D, Wang Y, Li F. Risk factors for bile leakage after primary closure following laparoscopic common bile duct exploration: a retrospective cohort study. BMC Surg 2017;17:1. [PMID: 28056934 PMCID: PMC5217550 DOI: 10.1186/s12893-016-0201-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 12/24/2016] [Indexed: 12/11/2022] Open

Ogura T, Higuchi K. A review of treatment options for bile duct stones. Expert Rev Gastroenterol Hepatol 2016;10:1271-1278. [PMID: 27410721 DOI: 10.1080/17474124.2016.1212658] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]

Park SM. Recent Advanced Endoscopic Management of Endoscopic Retrograde Cholangiopancreatography Related Duodenal Perforations. Clin Endosc 2016;49:376-82. [PMID: 27484814 PMCID: PMC4977750 DOI: 10.5946/ce.2016.088] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 07/18/2016] [Accepted: 07/18/2016] [Indexed: 02/06/2023] Open

Fujisawa T, Kagawa K, Hisatomi K, Kubota K, Nakajima A, Matsuhashi N. Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis? World J Gastroenterol 2016;22:5909-5916. [PMID: 27468185 PMCID: PMC4948272 DOI: 10.3748/wjg.v22.i26.5909] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 03/23/2016] [Accepted: 04/07/2016] [Indexed: 02/06/2023] Open

Veitch AM, Vanbiervliet G, Gershlick AH, Boustiere C, Baglin TP, Smith LA, Radaelli F, Knight E, Gralnek IM, Hassan C, Dumonceau JM. Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Gut 2016;65:374-89. [PMID: 26873868 PMCID: PMC4789831 DOI: 10.1136/gutjnl-2015-311110] [Citation(s) in RCA: 178] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]

Abstract

UNLABELLED

The risk of endoscopy in patients on antithrombotics depends on the risks of procedural haemorrhage versus thrombosis due to discontinuation of therapy. P2Y12 RECEPTOR ANTAGONISTS CLOPIDOGREL, PRASUGREL, TICAGRELOR: For low-risk endoscopic procedures we recommend continuing P2Y12 receptor antagonists as single or dual antiplatelet therapy (low quality evidence, strong recommendation); For high-risk endoscopic procedures in patients at low thrombotic risk, we recommend discontinuing P2Y12 receptor antagonists five days before the procedure (moderate quality evidence, strong recommendation). In patients on dual antiplatelet therapy, we suggest continuing aspirin (low quality evidence, weak recommendation). For high-risk endoscopic procedures in patients at high thrombotic risk, we recommend continuing aspirin and liaising with a cardiologist about the risk/benefit of discontinuation of P2Y12 receptor antagonists (high quality evidence, strong recommendation).

WARFARIN

The advice for warfarin is fundamentally unchanged from British Society of Gastroenterology (BSG) 2008 guidance.

DIRECT ORAL ANTICOAGULANTS DOAC

For low-risk endoscopic procedures we suggest omitting the morning dose of DOAC on the day of the procedure (very low quality evidence, weak recommendation); For high-risk endoscopic procedures, we recommend that the last dose of DOAC be taken ≥48 h before the procedure (very low quality evidence, strong recommendation). For patients on dabigatran with CrCl (or estimated glomerular filtration rate, eGFR) of 30-50 mL/min we recommend that the last dose of DOAC be taken 72 h before the procedure (very low quality evidence, strong recommendation). In any patient with rapidly deteriorating renal function a haematologist should be consulted (low quality evidence, strong recommendation).

Collapse

Zou YX, Yu DC. Diagnosis and treatment of cholelithiasis: A review based on meta-analyses. Shijie Huaren Xiaohua Zazhi 2016;24:879-885. [DOI: 10.11569/wcjd.v24.i6.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open

Small endoscopic sphincterotomy combined with endoscopic papillary large-balloon dilation in the treatment of patients with large bile duct stones. Eur Surg 2016. [DOI: 10.1007/s10353-016-0388-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]

Kim TH, Kim JH, Seo DW, Lee DK, Reddy ND, Rerknimitr R, Ratanachu-Ek T, Khor CJL, Itoi T, Yasuda I, Isayama H, Lau JYW, Wang HP, Chan HH, Hu B, Kozarek RA, Baron TH. International consensus guidelines for endoscopic papillary large-balloon dilation. Gastrointest Endosc 2016;83:37-47. [PMID: 26232360 DOI: 10.1016/j.gie.2015.06.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 06/11/2015] [Indexed: 12/11/2022]

Affiliation(s)

Tae Hyeon Kim Department of Gastroenterology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Republic of Korea
Jin Hong Kim Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea
Dong Wan Seo Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Dong Ki Lee Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Nageshwar D Reddy Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
Rungsun Rerknimitr Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Thawee Ratanachu-Ek Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
Christopher J L Khor Department of Gastroenterology and Hepatology, National University Health System, Tan Tock Seng Hospital, Singapore
Takao Itoi Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
Ichiro Yasuda Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan
Hiroyuki Isayama Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
James Y W Lau Department of Surgery, Endoscopic Center, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
Hsiu-Po Wang Endoscopic Division, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Hoi-Hung Chan Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Bing Hu Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, People's Republic of China
Richard A Kozarek Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, USA
Todd H Baron Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA

Collapse

Easler JJ, Sherman S. Endoscopic Retrograde Cholangiopancreatography for the Management of Common Bile Duct Stones and Gallstone Pancreatitis. Gastrointest Endosc Clin N Am 2015;25:657-75. [PMID: 26431596 DOI: 10.1016/j.giec.2015.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]

Jang JS, Lee S, Lee HS, Yeon MH, Han JH, Yoon SM, Chae HB, Youn SJ, Park SM. Efficacy and Safety of Endoscopic Papillary Balloon Dilation Using Cap-Fitted Forward-Viewing Endoscope in Patients Who Underwent Billroth II Gastrectomy. Clin Endosc 2015;48:421-7. [PMID: 26473126 PMCID: PMC4604281 DOI: 10.5946/ce.2015.48.5.421] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 10/17/2014] [Accepted: 10/21/2014] [Indexed: 12/20/2022] Open

Guo SB, Meng H, Duan ZJ, Li CY. Small sphincterotomy combined with endoscopic papillary large balloon dilation vs sphincterotomy alone for removal of common bile duct stones. World J Gastroenterol 2014;20:17962-17969. [PMID: 25548495 PMCID: PMC4273147 DOI: 10.3748/wjg.v20.i47.17962] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 07/13/2014] [Accepted: 08/28/2014] [Indexed: 02/07/2023] Open

Jang SI, Yun GW, Lee DK. Balloon dilation itself may not be a major determinant of post-endoscopic retrograde cholangiopancreatography pancreatitis. World J Gastroenterol 2014;20:16913-16924. [PMID: 25493004 PMCID: PMC4258560 DOI: 10.3748/wjg.v20.i45.16913] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 08/02/2014] [Accepted: 09/16/2014] [Indexed: 02/06/2023] Open