Papillary balloon dilation is not itself a cause of post-endoscopic retrograde cholangiopancreatography pancreatitis; results of anterograde and retrograde papillary balloon dilation

被引:30
作者
Seo, Yu Ri
Moon, Jong Ho
Choi, Hyun Jong
Kim, Dong Choon
Lee, Tae Hoon
Cha, Sang-Woo
Cho, Young Deok
Park, Sang-Heum
Kim, Sun-Joo
机构
[1] Soon Chun Hyang Univ, Sch Med, Ctr Digest Dis, Puchon 420767, South Korea
[2] Soon Chun Hyang Univ, Sch Med, Res Inst, Dept Internal Med, Puchon 420767, South Korea
[3] Soon Chun Hyang Univ, Sch Med, Ctr Digest Dis, Seoul, South Korea
[4] Soon Chun Hyang Univ, Sch Med, Res Inst, Dept Internal Med, Seoul, South Korea
关键词
endoscopic papillary balloon dilation; percutaneous transhepatic papillary balloon dilation; post-ERCP pancreatitis; BILE-DUCT STONES; BILIARY SPHINCTEROTOMY; PRESERVE SPHINCTER; ERCP PANCREATITIS; ODDI FUNCTION; MANAGEMENT; STENT; CHOLEDOCHOLITHIASIS; COMPLICATIONS; MULTICENTER;
D O I
10.1111/jgh.12277
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives The mechanism of pancreatitis development following endoscopic papillary balloon dilation (EPBD) remains unknown. Antegrade dilation with percutaneous transhepatic papillary balloon dilation (PTPBD) allows the removal of bile duct stones or fragments during percutaneous choledochoscopic lithotomy, with less mechanical trauma to the papilla than with EPBD-mediated stone removal. Methods A total of 56 patients with bile duct stones underwent antegrade dilation with PTPBD from March 2006 to February 2011. A total of 208 patients with common bile duct stones underwent retrograde dilation with EPBD during the same period. The conditions of papillary balloon dilation were identical in both groups. The frequencies of pancreatitis and hyperamylasemia were compared in both groups. Results Pancreatitis occurred in 14 (6.7%) of 208 patients in the EPBD group (mild, nine; moderate, four; severe, one). There was no case of pancreatitis among 56 patients in the PTPBD group (P<0.05). Hyperamylasemia developed in significantly more patients treated in the EPBD group (62, 29.8%) compared with the PTPBD group (4, 7.1%; P<0.05). Complete bile duct clearance was achieved in 98.2% of PTPBD group and 97.1% of EPBD group. Conclusions The rates of post-procedural pancreatitis and hyperamylasemia were significantly higher after retrograde dilation with EPBD than after antegrade dilation with PTPBD for the removal of bile duct stones. Although the mechanism of pancreatitis following papillary balloon dilation remains unclear, post-EPBD pancreatitis may be associated with procedures before and after balloon dilation similar to mechanical lithotripsy rather than balloon dilation itself.
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页码:1416 / 1421
页数:6
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