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Endoscopic Papillary Large Balloon Dilatation Without Sphincterotomy for the Treatment of Large Common Bile Duct Stone: Long-Term Outcomes at a Single Center

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Abstract

Background

Endoscopic papillary large balloon dilatation (EPLBD) without endoscopic sphincterotomy (EST) is an accepted, simplified endoscopic technique for large common bile duct (CBD) stone removal. However, little is known about the long-term outcomes of this technique. The purpose of this study was to evaluate the long-term outcomes of EPLBD without EST for the treatment of large CBD stones.

Methods

This retrospective study of EPLBD without EST for a large CBD stone was conducted between June 2005 and October 2010. A total of 128 patients with a large CBD stone were included. The primary outcome measurement was complete CBD stone removal after EPLBD. Clinical data obtained from medical records were analyzed.

Results

The overall complete stone removal rate was 94.5 %. Mechanical lithotripsy was needed in 18 (14.1 %) patients. Post-procedural pancreatitis and asymptomatic hyperamylasemia occurred in 1 (0.8 %) and 11 (8.6 %) patients, respectively. One (0.8 %) patient experienced minor bleeding. The rate of stone recurrence was 13.1 %, and median time to stone recurrence was 600 days (range 144–2284 days). Over a half (64.3 %) of stone recurrences occurred during the 2 years following stone removal. Recurrence tended to be more frequent in patients with a large CBD diameter and in patients requiring multiple endoscopic sessions for complete CBD stone retrieval.

Conclusion

EPLBD without EST may be safe and effective in patients with a large bile duct stone.

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Acknowledgments

This study was supported by an Inha University Hospital Grant.

Authors’ contribution

Jin-Seok Park, MD, contributed to study conception and design, collection and assembly of data, analysis and interpretation of the data, drafting of the article, and provision of study materials or patients. Byung Wook Bang, MD, was involved in collection and assembly of data and provision of study materials or patients. Ae Ra Kang, RN, helped in administrative and technical support. Seok Jeong, MD, and Don Haeng Lee, MD, contributed to study conception and design, critical revision of the article for important intellectual content, administration, and final approval of the article.

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Correspondence to Seok Jeong or Don Haeng Lee.

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The authors have no potential conflict of interest to declare.

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Seok Jeong and Don Haeng Lee have contributed equally to this work and share authorship.

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Park, JS., Jeong, S., Bang, B.W. et al. Endoscopic Papillary Large Balloon Dilatation Without Sphincterotomy for the Treatment of Large Common Bile Duct Stone: Long-Term Outcomes at a Single Center. Dig Dis Sci 61, 3045–3053 (2016). https://doi.org/10.1007/s10620-016-4220-4

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  • DOI: https://doi.org/10.1007/s10620-016-4220-4

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