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• W2038369891 abstract "Background: Outcome of endoscopic papillary balloon dilation (EPBD) for bile duct stones remains a conflicting matter to be settled. EPBD preserves the papillary function and is expected to provide favorable long-term outcome. Few data are available on long-term outcome. Methods: Between May 1994 and November 2004, a total of 1,000 patients with bile duct stones were treated with EPBD. Stone removal and early (<30 days) complications were evaluated. Patients were categorized into 4 groups according to gallbladder (GB) status; “cholecystectomy after EPBD”, “calculous GB”, “acalculous GB”, and “previous cholecystectomy” group, and long-term (≥30 days) outcomes were evaluated. Results: Complete bile duct clearance by EPBD alone was achieved in 963 patients (96.3%) with a mean of 1.5 endoscopic sessions. The success rate at one endoscopic session was significantly lower in patients with large (≥10 mm) stones than small (<10 mm) ones (31.6% vs7 9.8%, p < 0.0001). Post-EPBD pancreatitis developed in 48 patients (4.8%) including one patient graded as severe. Bleeding after EPBD occurred in 2 patients (0.2%). Long-term outcome was obtained for 818 patients with mean follow-up periods of 4.4 years. During follow-up, biliary events developed in 100 patients (12.2%), being less frequent in “cholecystectomy after EPBD” group than in “calculous GB”, “acalculous GB” and “prior cholecystectomy” group (.2.8% vs. 22.2%, 9.2%, 13.1%, respectively). Stone recurrence developed in 71 patients (8.7%); 2.4% in “cholecystectomy after EPBD”, 15.1% in “calculous GB”, 6.0% in “acalculous GB” and 11.2% in “prior cholecystectomy” group. Stone recurrence rate was significantly higher in “calculous GB” and “prior cholecystectomy” group (the relative risks against “cholecystectomy after EPBD”, 6.31 and 3.91, respectively). Cholecystitis occurred in 12 patients (4.3%) in “calculous GB” group and 2 patients (1.1%) in “acalculous GB” group. Conclusions: EPBD is an effective alternative for treatment of bile duct stones without increasing risk of pancreatitis, but multiple sessions were required in patients with large stones. Patients with calculous GB had the highest risk for late complications, and cholecystectomy after removal of bileduct stones is recommended." @default.
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• W2038369891 date "2006-04-01" @default.
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• W2038369891 title "Outcome in 1,000 Patients with Bile Duct Stones Treated with Endoscopic Papillary Balloon Dilation" @default.
• W2038369891 doi "https://doi.org/10.1016/j.gie.2006.03.784" @default.
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