Post-Sphincterotomy Transampullary Balloon Dilation Is Not Associated with An Increased Incidence of Post-ERCP Pancreatitis

Nathwani, Rahul A.; Banwait, Kuldip; Salese, Leonardo; Loren, David E.; Kowalski, Thomas E.

doi:10.1016/j.gie.2007.03.464

Cited by 1 publication

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“…Papillary dilation after sphincterotomy seems to be a different procedure than papillary dilation without a prior incision. As BS separates the pancreatic and biliary orifices, perhaps the expansive force of the inflated balloon is directed toward the bile duct rather than toward the Wirsung, and the incidence and severity of acute pancreatitis after BSD does not seem to be a major complication (15).…”

Section: Discussionmentioning

confidence: 99%

Biliary sphincterotomy dilation for the extraction of difficult common bile duct stones

García-Cano

Arana

Ayllón

et al. 2009

Rev. esp. enferm. dig.

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Background and aim: endoscopic retrograde cholangiopancreatography (ERCP) with biliary sphincterotomy (BS) is the usual method for extracting common bile duct stones. However, following BS and by means of extraction balloons and Dormia baskets a complete bile duct clearance cannot be achieved in all cases. We present a study on the impact that hydrostatic balloon dilation of a previous BS (BSD) may have in the extraction rate of choledocholithiasis. Patients and methods: a prospective study which included 91 consecutive patients diagnosed with choledocholithiasis who underwent ERCP. For stone removal, extraction balloons and Dormia baskets were used, and when necessary BSD was employed. Results: complete bile duct clearance was achieved in 86/91 (94.5%) patients. BSD was used in 30 (33%) cases. In these cases, extraction was complete in 29/30 (97%); 23 (76%) patients in the BSD group had anatomic difficulties or bleeding disorders. The most frequently used hydrostatic balloon diameter was 15 mm (60%). There were 7 (7.6%) complications: two self-limited hemorrhage episodes in the BSD group and one episode of cholangitis, one of pancreatitis, and three of bleeding in the group in which BSD was not used. Conclusions: BSD is a very valuable tool for extracting common bile duct stones. In our experience, there has been an increase in the extraction rate from 73% (Rev Esp Enferm Dig 2002; 94: 340-50) to 94.5% (p = 0.0001, OR 0.1, CI 0.05-0.45), with no increase in complications.

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Section: Discussionmentioning

confidence: 99%