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Comparison of Endoscopic Papillary Balloon Dilation and Sphincterotomy in Young Patients with CBD Stones and Gallstones

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Abstract

Background and Aims

Endoscopic biliary sphincterotomy (EBS) results in permanent loss of sphincter function and its long-term complications are unknown. Endoscopic papillary balloon dilation (EPBD) is an alternative procedure that preserves sphincter function, although it is associated with a higher risk of pancreatitis than is EBS. The aim of this study was to evaluate the safety and outcomes of EPBD with limited indications for removal of common bile duct (CBD) stones combined with gallstones in patients younger than 40 years.

Methods

Young (age < 40 years) patients who had CBD stones combined with gallstones on imaging studies were enrolled in this study. A total of 132 patients were randomly divided into the EPBD group (n = 62) or the EBS group (n = 70) for extraction of CBD stones. The ballooning size of EPBD ranged from 6 to 10 mm.

Results

Complete bile duct clearance was achieved in 98.4 % (61/62) of the EPBD group and 100 % (70/70) of the EBS group. Mechanical lithotripsy was required in 8.1 % (5/62) of the EPBD group and 8.6 % (6/70) of the EBS group. The early complication rates were 8.1 % (5/62) (five pancreatitis) in the EPBD group and 11.4 % (8/70) (five [7.1 %] pancreatitis, two bleeding and one perforation) in the EBS group. The recurrence rates of CBD stones were 1.6 % (1/62) in the EPBD group and 5.7 % (4/70) in the EBS group.

Conclusions

EPBD with limited indications was safe and effective as EBS for removal of CBD stones combined with gallstones in young patients who had a longer life expectancy.

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Abbreviations

EBS:

Endoscopic biliary sphincterotomy

BD:

Bile duct

EPBD:

Endoscopic papillary balloon dilation

CBD:

Common bile duct

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Acknowledgments

The corresponding author was supported in part by the SoonChunHyang University Research Fund.

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Authors and Affiliations

  1. Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea

    Yu Ri Seo, Jong Ho Moon, Hyun Jong Choi, Dong Choon Kim, Ji Su Ha, Tae Hoon Lee, Sang-Woo Cha, Young Deok Cho, Sang-Heum Park & Sun-Joo Kim

  2. Digestive Disease Center, SoonChunHyang University Bucheon Hospital, 1174 Jung-Dong, Wonmi-Ku, Bucheon, 420-767, Korea

    Jong Ho Moon

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  1. Yu Ri Seo
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  3. Hyun Jong Choi
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  5. Ji Su Ha
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Correspondence to Jong Ho Moon.

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Seo, Y.R., Moon, J.H., Choi, H.J. et al. Comparison of Endoscopic Papillary Balloon Dilation and Sphincterotomy in Young Patients with CBD Stones and Gallstones. Dig Dis Sci 59, 1042–1047 (2014). https://doi.org/10.1007/s10620-013-2949-6

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  • DOI: https://doi.org/10.1007/s10620-013-2949-6

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