Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2015; 3(4): 353-359
Published online Apr 16, 2015. doi: 10.12998/wjcc.v3.i4.353
Endoscopic papillary large balloon dilation for bile duct stones in elderly patients
Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Reina Sasaki, Dai Sakamoto, Masato Nakamura, Yuuto Watanabe, Takao Nishikawa, Shin Yasui, Rintaro Mikata, Osamu Yokosuka
Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Reina Sasaki, Dai Sakamoto, Masato Nakamura, Yuuto Watanabe, Takao Nishikawa, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8677, 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, Sugiyama H, Nishikawa T, Yasui S, and Mikata R performed endoscopic treatment; Sasaki R, Sakamoto D, Nakamura M and Watanabe Y were responsible for data collection.
Ethics approval: This study was performed after approval of the ethical committee of our institution.
Informed consent: All treatment procedures were performed after obtaining a written informed consent from the patients.
Conflict-of-interest: The authors have no disclosures.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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: July 7, 2014
Peer-review started: July 8, 2014
First decision: August 14, 2014
Revised: November 24, 2014
Accepted: February 9, 2015
Article in press: February 11, 2015
Published online: April 16, 2015
Abstract

AIM: To investigate whether endoscopic papillary large balloon dilation (EPLBD) can be safety and effectively performed in patients aged ≥ 80 years.

METHODS: Lithotomy by EPLBD was conducted in 106 patients with bile duct stones ≥ 13 mm in size or with three or more bile duct stones ≥ 10 mm. The patients were divided into group A (< 80 years) and group B (≥ 80 years). Procedure success rate, number of endoscopic retrograde cholangiopancreatographies (ERCP), and incidence of complications were examined in both groups.

RESULTS: Group B tended to include significantly more patients with peripapillary diverticulum, hypertension, hyperlipemia, cerebrovascular disease/dementia, respiratory disease/cardiac disease, and patients administered an anticoagulant or antiplatelet agent (P < 0.05). The success rate of the initial lithotomy was 88.7 (94/106)%. The final lithotomy rate was 100 (106/106)%. Complications due to treatment procedure occurred in 4.72 (5/106)% of the patients. There was no significant difference in procedure success rate, number of ERCP, or incidence of complications between group A and group B.

CONCLUSION: EPLBD can be safely performed in elderly patients, the same as in younger patients.

Keywords: Elderly patients, Endoscopic papillary large balloon dilation, Endoscopic sphincterotomy, Large bile duct stones, Choledocholithiasis

Core tip: Endoscopic treatment by papillary large balloon dilation for large stones can be safely performed in elderly patients, the same as in younger patients.