Predictive factors for acute pancreatitis and hyperamylasemia after endoscopic papillary balloon dilation

Sugiyama, Masanori; Izumisato, Yumi; Abe, Nobutsugu; Terabe, Masaki; Mori, Toshiyuki

doi:10.1067/mge.2003.143

Cited by 32 publications

(32 citation statements)

References 21 publications

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“…37 According to another study, previous pancreatitis history is one of the most significant factor of EPBD related pancreatitis (odds ratio [OR], 10.69; 95% confidence interval [CI], 1.57-72.97). 36 In contrast, another study revealed that history of acute pancreatitis was not identified as a risk factor, but that contrast medium injection to the pancreas was a significant risk factor by multivariate analysis (OR, 3.788; 95% CI, 1.036-13.853). As Chinese study showed younger age to be a significant risk factor for post-ERCP pancreatitis (OR, 1.59; 95% CI, 1.06-2.39).…”

Section: Complications 1) Post-epbd Pancreatitismentioning

confidence: 87%

“…36 Total procedure time, sex, periampullary diverticulum, mechanical lithotripsy, non-dilated bile duct and difficult cannulation were found not to be significant by univariate and multivariate analysis. 32,36 However, cannulation trauma might result in spasm of the sphincter of Oddi and/or hemorrhagic edematous change, 33 and was a potential risk factor for asymptomatic hyperamylasemia after EPBD (OR, 5.12; 95% CI, 2.79-16.81). 36 In cases of difficult cannulation, minimal EST before standard endoscopic balloon dilation may be recommended.…”

Section: Complications 1) Post-epbd Pancreatitismentioning

confidence: 99%

“…39 However, there was no significant difference in the incidence of post-EPBD pancreatitis between older and younger patients. 32,36 However, age of younger than 60 years demonstrated relevance to asymptomatic hyperamylasemia. 36 Total procedure time, sex, periampullary diverticulum, mechanical lithotripsy, non-dilated bile duct and difficult cannulation were found not to be significant by univariate and multivariate analysis.…”

Section: Complications 1) Post-epbd Pancreatitismentioning

confidence: 99%

“…32,36 However, age of younger than 60 years demonstrated relevance to asymptomatic hyperamylasemia. 36 Total procedure time, sex, periampullary diverticulum, mechanical lithotripsy, non-dilated bile duct and difficult cannulation were found not to be significant by univariate and multivariate analysis. 32,36 However, cannulation trauma might result in spasm of the sphincter of Oddi and/or hemorrhagic edematous change, 33 and was a potential risk factor for asymptomatic hyperamylasemia after EPBD (OR, 5.12; 95% CI, 2.79-16.81).…”

Section: Complications 1) Post-epbd Pancreatitismentioning

confidence: 99%

“…Smaller balloons of less than 8mm may be safer and more effective in the management of bile duct stones, and decrease the incidence of pancreatitis. 30,36 Balloon dilation in a stepwise fashion, avoiding rapid application and excessive pressure, may also contribute to decreasing the occurrence of the post-EPBD pancreatitis. 37 According to another study, previous pancreatitis history is one of the most significant factor of EPBD related pancreatitis (odds ratio [OR], 10.69; 95% confidence interval [CI], 1.57-72.97).…”

Section: Complications 1) Post-epbd Pancreatitismentioning

confidence: 99%

See 4 more Smart Citations

Endoscopic Papillary Balloon Dilation for Removal of Choledocholithiasis: Indications, Advantages, Complications, and Long-Term Follow-Up Results

Chung¹,

Chung²

2011

Gut Liver

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Endoscopic papillary balloon dilation (EPBD) is an alternative method of endoscopic sphincterotomy (EST). Although concerns regarding post-procedure pancreatitis have been expressed, EPBD has come to be recognized as an effective and safe method for stone removal in specific cases. To analyze the proper indications, ideal methods, complications, and long-term follow-up results for EPBD, we reviewed articles about EPBD located through a search of the PubMed data base. We analyzed the ballooning methods, indications, results and complications of EPBD among the articles found and compared the results with those of EST. We considered the authors' own clinical experience and knowledge in developing recommendations for EPBD. EPBD showed similar effi cacy and safety for the removal of choledocholithiasis to that of EST. Although large or multiple stones were diffi cult to remove by EPBD, it was safer and easier to apply in patients with coagulopathy or abnormal anatomy. To prevent severe pancreatitis, excessive ballooning and impractical cannulation should be avoided, and precut sphincterotomy or adjuvant prophylaxis should be considered. Due to its preservation of the sphincter of Oddi, EPBD is expected to have fewer long-term complications, such as stone recurrence, cholangitis and cholecystitis. In conclusion, EPBD appears to be safe and effective for the treatment of choledocholithiasis with proper selection of ballooning methods and patients. (Gut Liver 2011;5:1-14)

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Section: Complications 1) Post-epbd Pancreatitismentioning

confidence: 87%