Balloon dilation itself may not be a major determinant of post-endoscopic retrograde cholangiopancreatography pancreatitis

doi:10.3748/wjg.v20.i45.16913

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World J Gastroenterol. Dec 7, 2014; 20(45): 16913-16924
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.16913

Table 1 Frequency and severity of pancreatitis and complications after endoscopic papillary balloon dilation

Ref.	Study design	Study’s location	Comparison groups (n)	Pancreatitis n (%)	Pancreatitis severity (n)			Other complications (n)			OverallAEs-related death (n)
Ref.	Study design	Study’s location	Comparison groups (n)	Pancreatitis n (%)	Mild/moderate	Severe	Death	Bleeding	Perforation	Cholangitis	OverallAEs-related death (n)
Minami et al[85], (1995)	RCT	Japan	EPBD (n = 20)	2 (10)	2	0	0	0	0	0	0
Minami et al[85], (1995)	RCT	Japan	EST (n = 20)	2 (10)	2	0	0	0	0	0	0
Mathuna et al[86], (1995)	R	Ireland	EPBD (n = 100)	5 (4.8)	5	0	0	0	0	0	0
Bergman et al[46], (1997)	RCT	The Netherlands	EPBD (n = 101)	7 (6.9)	5	2	0	0	2	0	0
Bergman et al[46], (1997)	RCT	The Netherlands	EST (n = 101)	7 (6.9)	6	1	0	4	1	0	1
Yasuda et al[87], (1998)	P	Japan	EPBD (n = 92)	8 (8.7)	8	0	0	0	0	0	0
Ueno et al[55], (1999)	R	Japan	EPBD (n = 109)	21 (19.8)	21	0	0	NA	NA	NA	0
Ochi et al[88], (1999)	RCT	Japan	EPBD (n = 55)	0	0	0	0	0	0	0	0
Ochi et al[88], (1999)	RCT	Japan	EST (n = 55)	2 (3.6)	2	0	0	0	1	0	0
Arnold et al[51], (2001)	RCT	Germany	EPBD (n = 30)	6 (20.0)	4	2	0	0	0	3	0
Arnold et al[51], (2001)	RCT	Germany	EST (n = 30)	3 (10.0)	3	0	0	2	0	0	0
Bergman et al[53], (2001)	RCT	The Netherlands	EPBD (n = 93)	7 (7.5)	5	2	0	0	2	0	1
Bergman et al[53], (2001)	RCT	The Netherlands	EST (n = 87)	7 (8.0)	6	1	0	2	0	0	0
Yasuda et al[43], (2001)	RCT	Japan	EPBD (n = 35)	2 (5.7)	2	0	0	0	0	0	0
Yasuda et al[43], (2001)	RCT	Japan	EST (n = 35)	2 (5.7)	2	0	0	1	0	0	0
Natsui et al[89], (2002)	RCT	Japan	EPBD (n = 70)	4 (5.7)	4	0	0	0	0	2
Natsui et al[89], (2002)	RCT	Japan	EST (n = 70)	3 (4.3)	3	0	0	2	0	3
Fujita et al[49], (2003)	RCT	Japan	EPBD (n = 138)	15 (10.9)	15	0	0	0	0	2	0
Fujita et al[49], (2003)	RCT	Japan	EST (n = 144)	4 (2.7)	4	0	0	2	0	6	0
Vlavianos et al[48], (2003)	RCT	United Kindom	EPBD (n = 103)	5 (4.9)	4	1	0	0	0	2	0
Vlavianos et al[48], (2003)	RCT	United Kindom	EST (n = 99)	1 (1.0)	1	0	0	0	0	1	1
Sugiyama et al[54], (2003)	R	Japan	EPBD (n = 118)	7 (6.0)	7	0	0	0	0	0	0
Lin et al[90], (2004)	RCT	Taiwan	EPBD (n = 51)	0	0	0	0	1	0	0	0
Lin et al[90], (2004)	RCT	Taiwan	EST (n = 53)	0	0	0	0	14	0	0	0
Disario et al[50], (2004)	RCT	United States	EPBD (n = 117)	18 (15.4)	12	6	2	11	0	1	2
Disario et al[50], (2004)	RCT	United States	EST (n = 120)	1 (0.8)	1	0	0	32	1	1	0
Tanake et al[91], (2004)	RCT	Japan	EPBD (n = 16)	3 (18.8)	1	2	0	0	0	0	0
Tanake et al[91], (2004)	RCT	Japan	EST (n = 16)	3 (18.8)	2	1	0	0	0	2	0
Toda et al[92], (2005)	RCT	Japan	EPBD (n = 94)	7 (6.4)	7	0	0	0	0	4	0
Toda et al[92], (2005)	RCT	Japan	EST (n = 102)	3 (3)	3	0	0	2	2	4	0
Tsujino et al[11], (2005)	R	Japan	EPBD (n = 304)	15 (5.0)	15	0	0	0	1	6	0
Nakagawa et al[93], (2006)	R	Japan	EPBD (n = 201)	2 (1.0)	0	2	0	0	0	3	0
Tsujino et al[42], (2007)	P	Japan	EPBD (n = 1000)	48 (4.8)	47	1	0	2	2	27	2
Ito et al[35], (2008)	R	Japan	EPBD (n = 406)	19 (5.7)	19	0	0	0	1	4	0
Liao et al[94], (2008)	RCT	Taiwan	EPBD (n = 35)	2 (5.7)	2	0	0	0	0	1	0
Liao et al[94], (2008)	RCT	Taiwan	EST (n = 25)	3 (12)	3	0	0	2	0	2	0
Natsui et al[95], (2011)	RCT	Japan	EPBD (n = 41)	2 (4.8)	2	0	0	0	0	1	0
Natsui et al[95], (2011)	RCT	Japan	EST (n = 42)	1 (2.3)	1	0	0	0	0	1	0
Kuo et al[96], (2012)	R	Taiwan	EPBD (n = 273)	30 (10.1)	22	8	0	1	1	9	1
Seo et al[97], (2014)	RCT	South Korea	EPBD (n = 62)	5 (8.1)	5	0	0	0	0	0	0
Seo et al[97], (2014)	RCT	South Korea	EST (n = 70)	5 (7.1)	5	0	0	2	1	0	0

EST: Endoscopic sphincterotomy; AEs: Adverse events; EPBD: Endoscopic papillary balloon dilation; R: Retrospective; P: Prospective; RCT: Randomized controlled trial; NA: Not available.

Table 2 Frequency and severity of pancreatitis and complications after endoscopic papillary large balloon dilation with endoscopic sphincterotomy

Ref.	Study design	Study’s location	Comparison groups (n)	Balloon diameter (mm)	Pancreatitisn (%)	Pancreatitis severity (n)			Other complications (n)			Overall AEs-related death (n)
Ref.	Study design	Study’s location	Comparison groups (n)	Balloon diameter (mm)	Pancreatitisn (%)	Mild/moderate	Severe	death	Bleeding	Perforation	Cholangitis	Overall AEs-related death (n)
Ersoz et al[31], (2003)	R	Turkey	EPLBD (n = 58)	12-20	2 (3.4)	2	0	0	5	0	2	0
Maydeo et al[60], (2007)	P	India	EPLBD (n = 60)	12-20	0 (0)	0	0	0	5	0	0	0
Minami et al[62], (2007)	R	Japan	EPLBD (n = 88)	20	1 (1.1)	1	0	0	1	0	1	0
Heo et al[61], (2007)	RCT	South Korea	EPLBD (n = 100)	12-20	4 (4.0)	4	0	0	0	0	0	0
			EST (n = 100)	-	4 (4.0)	4	0	0	2	0	0	0
Lee et al[98], (2007)	R	South Korea	EPLBD (n = 55)	15-20	0 (0)	0	0	0	2	0	0	0
Kim et al[99], (2007)	R	South Korea	EPLBD (n = 35)	12-20	0 (0)	0	0	0	0	1	0	0
Lee et al[100], (2007)	R	South Korea	EPLBD (n = 41)	13-20	2 (4.8)	0	0	0	1	0	0	0
Misra et al[101], (2008)	R	India	EPLBD (n = 50)	15-20	4 (8.0)	4	0	0	3	0	0	0
Attasaranya et al[63], (2008)	R	United States	EPLBD (n = 103)	12-18	0 (0)	0	0	0	2	1	0	0
Espinel et al[102], (2008)	P	Spain	EPLBD (n = 93)	12-20	1 (1.1)	1	0	0	1	0	0	0
Itoi et al[103], (2009)	R	Japan	EPLBD (n = 53)	15-20	1 (1.9)	1	0	0	0	0	1	0
			EST (n = 48)	-	2 (4.1)	2	0	0	0	0	1	0
Kim et al[104], (2009)	RCT	South Korea	EPLBD (n = 27)	15-18	0 (0)	0	0	0	4	0	0	0
			EST (n = 28)	-	0 (0)	0	0	0	2	0	0	0
Itoi et al[105], (2010)	R	Japan	EPLBD (n = 18)	15-18	0 (0)	0	0	0	0	0	0	0
Kurita et al[106], (2010)	R	Japan	EPLBD (n = 24)	15-20	0 (0)	0	0	0	0	0	0	0
Ghazanfar et al[107], (2010)	P	Pakistan	EPLBD (n = 84)	15-18	3 (3.6)	3	0	0	3	0	0	1
Kim et al[108], (2010)	R	South Korea	EPLBD (n = 70)	12-18	1 (2.3)	1	0	0	0	0	0	0
Youn et al[65], (2011)	R	South Korea	EPLBD (n = 101)	15-20	2 (2.0)	2	0	0	2	1	0	0
Kim et al[109], (2011)	R	South Korea	EPLBD (n = 72)	12-20	5 (6.9)	5	0	0	0	0	1	0
			EST (n = 77)	-	9 (11.7)	9	0	0	0	1	0	0
Stefanidis et al[75], (2011)	RCT	Greece	EPLBD (n = 45)	15-20	1 (2.2)	1	0	0	1	0	0	0
			EST (n = 45)	-	1 (2.2)	1	0	0	1	1	6	0
Rebelo et al[67], (2012)	R	Portugal	EPLBD (n = 30)	12-18	1 (3.3)	1	0	0	0	0	0	0
Sakai et al[110], (2013)	R	Japan	EPLBD (n = 59)	12-20	0 (0)	0	0	0	1	1	0	0
Park et al[37], (2013)	R	South Korea, Japan	EPLBD (n = 946)	12-20	24 (25.3)	24	0	0	56	9	6	4
Poincloux et al[64], (2013)	R	France	EPLBD (n = 64)	15-20	2 (3.1)	2	0	0	5	0	0	0
Hwang et al[73], (2013)	R	South Korea	EPLBD (n = 69)	12-20	3 (4.3)	3	0	0	0	1	0	0
Paspatis et al[68], (2013)	RCT	Greece	60 s dilation¹ (n = 60)	15-20	2 (1.6)	2	0	0	4	1	3	0
			30 s dilation¹ (n = 64)	15-20	2 (1.6)	1	1	1	2	1	2	1
Rosa et al[66], (2013)	R	Portugal	EPLBD (n = 68)	12-18	9 (13.2)	9	0	0	0	0	1	0
			EST (n = 45)	-	2 (4.7)	2	0	0	0	0	1	0
Yang et al[111], (2013)	R	China	EPLBD (n = 171)	12-18	2 (1.2)	2	0	0	4	1	1	0
Yoon et al[112], (2013)	P	South Korea	EPLBD (n = 52)	12-20	0 (0)	0	0	0	0	0	0	0
Harada et al[113], (2013)	R	Japan	EPLBD (n = 30)	15-20	0 (0)	0	0	0	0	0	0	0

¹Sixty and thirty seconds mean the duration of balloon dilation (s) in endoscopic papillary large balloon dilation (EPLBD). AEs: Adverse events; EST: Endoscopic sphincterotomy; R: Retrospective; P: Prospective; RCT: Randomized controlled trial.

Table 3 Frequency and severity of pancreatitis and complications after endoscopic papillary large balloon dilation without endoscopic sphincterotomy

Ref.	Years	Study design	Patients(n)	Pancreatitis n (%)	Pancreatitis severity (n)				Other complications (n)			Overall AEs-related death (n)
Ref.	Years	Study design	Patients(n)	Pancreatitis n (%)	Mild	Moderate	Severe	Death	Bleeding	Perforation	Cholangitis	Overall AEs-related death (n)
Jeong et al[34]	2009	R	38	1 (2.6)	1	0	0	0	0	0	0	0
Chan et al[72]	2011	R	247	2 (0.8)	2	0	0	0	0	0	1	0
Hwang et al[73]	2013	R	62	4 (6.4)	4	0	0	0	0	0	0	0

AEs: Adverse events; R: Retrospective.

Citation: 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(45): 16913-16924
URL: https://www.wjgnet.com/1007-9327/full/v20/i45/16913.htm
DOI: https://dx.doi.org/10.3748/wjg.v20.i45.16913