Endoscopic large-balloon sphincteroplasty without preceding sphincterotomy for the removal of large bile duct stones: a preliminary study
| Autor: | Kye Sook Kwon, Don Haeng Lee, Hyung Gil Kim, Sung-Ho Ki, Seok Jeong, Jung Il Lee, Jin-Woo Lee, Young Soo Kim, Yong Woon Shin |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Lithotripsy Balloon Severity of Illness Index Asymptomatic Catheterization Sphincterotomy Endoscopic Humans Medicine Duodenoscopes Radiology Nuclear Medicine and imaging Aged Retrospective Studies Aged 80 and over Cholangiopancreatography Endoscopic Retrograde medicine.diagnostic_test Common bile duct business.industry Bile duct Contraindications Gastroenterology Retrospective cohort study Middle Aged medicine.disease Endoscopy Surgery Choledocholithiasis Treatment Outcome medicine.anatomical_structure Pancreatitis Female medicine.symptom business Follow-Up Studies |
| Zdroj: | Gastrointestinal Endoscopy. 70:915-922 |
| ISSN: | 0016-5107 |
| Popis: | Background Endoscopic sphincterotomy (EST) has usually been performed before large-balloon sphincteroplasty (LBS) to retrieve large bile duct stones because of the high risk of pancreatitis and some advantages of EST. However, there are no available data on the preceding EST to confirm these assertions. Objective We investigated the safety and efficacy of LBS without a preceding EST for the management of large bile duct stones. Design Single-institution retrospective study. Setting Tertiary referral center. Patients Thirty-eight patients with large bile duct stones. Interventions Endoscopic LBS without preceding EST. Main Outcome Measurements Efficacy of stone removal and complications related to the procedure. Results The overall success rate irrespective of whether mechanical lithotripsy (ML) was used was 97.4% (37/38). Complete duct clearance by LBS alone without ML was achieved in 29 (76.3%) patients. Complete stone retrieval was achieved by LBS alone in the first session in 25 (65.8%) patients. ML was required in 8 (21.1%) patients. Failure to extract a stone occurred in 1 (2.6%) patient. There was a mild degree of postprocedure pancreatitis in only 1 (2.6%) patient and asymptomatic hyperamylasemia in 3 (7.9%) patients. The maximum diameters of the stones and the balloon/stone diameter ratio had a tendency to affect complete stone retrieval in the success and failure groups: 16.7 ± 3.9 mm vs 20.8 ± 6.5 mm and 0.96 ± 0.19 mm vs 0.80 ± 0.23 mm, respectively (results are presented as mean ± standard deviation). Limitations Small-scale, single-arm study. Conclusions Our data suggest that LBS without EST is safe and effective in patients with large bile duct stones. |
| Databáze: | OpenAIRE |
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