Clinical Trials Study
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World J Gastroenterol. Dec 7, 2014; 20(45): 17148-17154
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.17148
Endoscopic papillary large balloon dilation for removal of bile duct stones
Yuji Sakai, Toshio Tsuyuguchi, Yoshiaki Kawaguchi, Nobuto Hirata, So Nakaji, Katsuya Kitamura, Shigeru Mikami, Tatsuya Fujimoto, Masashi Ijima, Eishin Kurihara, Shuhei Oana, Takayoshi Nishino, Ryo Tamura, Dai Sakamoto, Masato Nakamura, Takao Nishikawa, Harutoshi Sugiyama, Hitoshi Yoshida, Tetsuya Mine, Osamu Yokosuka
Yuji Sakai, Toshio Tsuyuguchi, Ryo Tamura, Dai Sakamoto, Masato Nakamura, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Yoshiaki Kawaguchi, Tetsuya Mine, Department of Gastroenterology, Tokai University Hospital, Kanagawa 250-0134, Japan
Nobuto Hirata, So Nakaji, Department of Gastroenterology, Kameda Medical Center, Chiba 260-8670, Japan
Katsuya Kitamura, Hitoshi Yoshida, Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Tokyo 142-855, Japan
Shigeru Mikami, Department of Internal Medicine, Kikkoman General Hospital, Chiba 260-8670, Japan
Tatsuya Fujimoto, Department of Gastroenterology, Kimitsu Central Hospital, Chiba 260-8670, Japan
Masashi Ijima, Eishin Kurihara, Department of Gastroenterology, Isesaki Municipal Hospital, Gunma 370-0344, Japan
Shuhei Oana, Department of Gastroenterology, Iwate Medical University Hospital, Iwate 020-8505, Japan
Takayoshi Nishino, Department of Gastroenterology, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 260-8670, Japan
Author contributions: Sakai Y, Tsuyuguchi T and Yokosuka O were responsible for study design, data analysis, and manuscript preparation; Sakai Y wrote the paper; Sakai Y, Tsuyuguchi T, Kawaguchi Y, Hirata N, Nakaji S, Kitamura K, Mikami S, Fujimoto T, Ijima M, Kurihara E, Oana S, Nishino T, Tamura R, Nishikawa T, Sugiyama H, Yoshida H and Mine T performed endoscopic treatment; Sakamoto D and Nakamura M were responsible for data collection.
Correspondence to: Yuji Sakai, MD, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuou-ku, Chiba 260-8670, Japan. sakai4754@yahoo.co.jp
Telephone: +81-43-2262083 Fax: +81-43-2262088
Received: May 13, 2014
Revised: July 1, 2014
Accepted: July 29, 2014
Published online: December 7, 2014
Processing time: 210 Days and 23.7 Hours
Abstract

AIM: To investigate the efficacy and outcomes of endoscopic papillary large balloon dilation (EPLBD) for bile duct stones in a multicenter prospective study.

METHODS: Lithotomy by EPLBD was conducted in 124 patients with bile duct stones ≥ 13 mm in size or with three or more bile duct stones ≥ 10 mm. After endoscopic sphincterotomy, the papilla was dilated using balloons 12-20 mm in diameter fitting the bile duct diameter.

RESULTS: The success rate of first-time lithotomy was 86.3% (107/124) and the final lithotomy success rate was 100% (124/124). Lithotripsy was needed in 10 of the 124 (13.6%) patients. Adverse events due to the treatment procedure occurred in 6 (4.8%) patients, all of which were mild. Performing large balloon dilation after endoscopic sphincterotomy in patients with large stones or multiple stones in the bile duct is considered to ensure the safety of treatment and to reduce the need for lithotripsy.

CONCLUSION: It is suggested that treatment by EPLBD for large bile duct stones may be safe and useful.

Keywords: Endoscopic retrograde cholangiopancreatography; Endoscopic sphincterotomy; Endoscopic papillary large balloon dilation; Large bile duct stones; Multiple bile duct stones

Core tip: Endoscopic treatment by papillary large balloon dilation for large stones or multiple stones may be safe and useful.