Document Detail

What is an appropriate indication for endoscopic papillary balloon dilation?
MedLine Citation:
PMID:  12072597     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: There are a number of views on the indication for endoscopic papillary balloon dilation (EPBD) in the management of bile duct stones. In this study, we have evaluated the efficacy and safety of EPBD compared with endoscopic sphincterotomy (EST).
DESIGN: Prospective randomized trial.
SETTING: One university hospital and one general hospital.
PARTICIPANTS AND MAIN OUTCOME MEASURES: One hundred and forty patients were randomly allocated to EPBD or EST. Outcomes and complications were observed for a median period of 30 months.
RESULTS: Both treatment approaches finally achieved similar success rates and needed similar numbers of treatment sessions for patients with stones less than 10 mm in diameter. However, for patients with stones of 10 mm or more, EPBD required a significantly greater mean number of treatment sessions than EST (2.4 vs 1.6, P < 0.01). Early complications occurred in seven EPBD (four pancreatitis, two cholangitis and one basket impaction) and eight EST (three pancreatitis, two bleeding and three cholangitis) patients. Late complications occurred in four EPBD (three recurrent bile duct stones and one cholecystitis) and six EST (three recurrent stones and three cholecystitis) patients.
CONCLUSIONS: EPBD has little risk of bleeding. The technique removed small bile duct stones just as easily as did EST. These two procedures had approximately the same risk of pancreatitis and incidence of recurrent bile duct stones. Therefore, both procedures appear to be appropriate treatments for small bile duct stones. Whether or not EPBD becomes an established treatment will depend on further long-term studies.
Masaaki Natsui; Rintaro Narisawa; Hirotaka Motoyama; Shun-Ichi Hayashi; Keiichi Seki; Hiroto Wakabayashi; Shin-Ichi Itoh; Hitoshi Asakura
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  14     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-19     Completed Date:  2002-09-06     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  635-40     Citation Subset:  IM    
Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, Japan.
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MeSH Terms
Aged, 80 and over
Ampulla of Vater*
Balloon Dilation* / adverse effects,  methods
Cholecystitis / etiology
Cholelithiasis / therapy*
Middle Aged
Pancreatitis / etiology
Prospective Studies
Sphincterotomy, Endoscopic / adverse effects
Treatment Outcome

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