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CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(11): E1027-E1034
DOI: 10.1055/s-0043-118479
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Multicenter retrospective and comparative study of 5-minute versus 15-second endoscopic papillary balloon dilation for removal of bile duct stones

Ryunosuke Hakuta
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
2   Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan
,
Tsuyoshi Hamada
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
3   Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
,
Yousuke Nakai
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Hiroyuki Isayama
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Hirofumi Kogure
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Suguru Mizuno
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Takahara Naminatsu
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Hiroshi Yagioka
4   Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Tokyo, Japan
,
Osamu Togawa
5   Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan
,
Saburo Matsubara
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Yukiko Ito
2   Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan
,
Natsuyo Yamamoto
6   Department of Gastroenterology, Toshiba General Hospital, Tokyo, Japan
,
Takeshi Tsujino
2   Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan
7   Division of Gastroenterology and Hepatology, H.H. Chao Comprehensive Digestive Disease Center, University of California, Irvine School of Medicine, CA, USA
,
Kazuhiko Koike
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

submitted 02 March 2017

accepted after revision 24 July 2017

Publication Date:
26 October 2017 (online)

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Abstract

Background and study aims Endoscopic papillary balloon dilation (EPBD) is a method of bile duct stone removal that has a better long-term outcome but a high risk of post-ERCP pancreatitis (PEP). Recent studies have suggested that 5-minute EPBD can reduce the incidence of PEP. This study aimed to examine the safety and effectiveness of longer duration EPBD compared with shorter duration EPBD (5 minutes vs. 15 seconds after disappearance of the waist of a dilation catheter).

Patients and methods Patients without a history of endoscopic sphincterotomy or EPBD who underwent EPBD to remove bile duct stones were selected retrospectively from five centers. The incidence of PEP, other early adverse events, and outcomes of EPBD were compared between the groups. A multivariable analysis of risk factors for PEP was performed.

Results A total of 607 patients (157 and 450 in the 5-minute and 15-second EPBD groups, respectively) were included. There were no statistically significant differences between the groups in terms of the incidence of PEP (8.3 % and 8.9 % in the 5-minute and 15-second EPBD groups, respectively; P = 0.871) and the incidence of overall early adverse events (P = 0.999). Although 5-minute EPBD elongated the procedure time (45 vs. 37 minutes, P < 0.001), it increased the rate of complete stone removal during a single session (P < 0.001) and decreased the use of lithotripsy (P < 0.001).

Conclusions Compared with 15-second EPBD, 5-minute EPBD did not reduce the incidence of PEP.

 

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