Optimal dilation duration of 10 mm diameter balloons after limited endoscopic sphincterotomy for common bile duct stones: a randomized controlled trial.

Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
10 Jan 2024
Historique:
received: 02 07 2023
accepted: 28 12 2023
medline: 11 1 2024
pubmed: 11 1 2024
entrez: 10 1 2024
Statut: epublish

Résumé

Limited endoscopic sphincterotomy (EST) combined with endoscopic papillary balloon dilation (EPBD) is widely used. However, the optimal duration of small balloon dilation in choledocholithiasis remains controversial. We aimed to determine the optimal duration for 10 mm diameter balloon dilation after limited EST in choledocholithiasis. In this randomized controlled clinical trial, 320 patients were randomly assigned to receive small balloon dilation (10 mm in diameter) for 1 min (n = 160) or 3 min (n = 160) after deep bile duct cannulation. No significant difference in success rate of stone extraction between the two groups was observed. The incidence of post-ERCP pancreatitis (PEP) was higher in the 1 min group (10.6%) than in the 3 min group (4.4%) (P = 0.034). The logistic regression analysis showed that guidewire into the pancreatic duct, cannulation time > 5 min and 1 min balloon dilation were independent risk factors for PEP. There were no significant differences in other post-ERCP adverse events such as acute cholangitis, bleeding, perforation, etc. between the two groups. In conclusion, 3 min in duration was determined to be the optimal dilation condition for the removal of common bile duct stones.

Identifiants

DOI: 10.1038/s41598-023-50949-w PMID: 38200057
pubmed: 38200057
doi: 10.1038/s41598-023-50949-w
pii: 10.1038/s41598-023-50949-w
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

971

Subventions

Organisme : Science and Technology Research Project of Education Department of Jiangxi Province
ID : GJJ200104
Organisme : Jiangxi Provincial Degree and Graduate Education Teaching Reform Research Project
ID : JXYJG-2021-039
Organisme : Jiangxi Provincial Degree and Graduate Education Teaching Reform Research Project
ID : No. JXYJG-2022-020
Organisme : Research project on teaching reform in higher education institutions in Jiangxi Province
ID : No. JXJG-22-1-20
Organisme : Research project on teaching reform at Nanchang University
ID : NCUJGLX-2022-160-91

Informations de copyright

© 2024. The Author(s).

Références

Classen, M. & Demling, L. Endoscopic sphincterotomy of the papilla of vater and extraction of stones from the choledochal duct. Dtsch. Med. Wochenschr. 99, 496–497 (1974).
doi: 10.1055/s-0028-1107790 pubmed: 4835515
Kawai, K., Akasaka, Y., Murakami, K., Tada, M. & Koli, Y. Endoscopic sphincterotomy of the ampulla of Vater. Gastrointest. Endosc. 20, 148–151 (1974).
doi: 10.1016/S0016-5107(74)73914-1 pubmed: 4825160
Zhao, H. C., He, L., Zhou, D. C., Geng, X. P. & Pan, F. M. Meta-analysis comparison of endoscopic papillary balloon dilatation and endoscopic sphincteropapillotomy. World J. Gastroenterol. 19, 3883–3891 (2013).
doi: 10.3748/wjg.v19.i24.3883 pubmed: 23840129 pmcid: 3699051
Staritz, M., Ewe, K. & Meyer zumBüschenfelde, K. H. Endoscopic papillary dilation (EPD) for the treatment of common bile duct stones and papillary stenosis. Endoscopy 15(Suppl 1), 197–198 (1983).
doi: 10.1055/s-2007-1021507 pubmed: 6872989
Karsenti, D. et al. Complete endoscopic sphincterotomy with vs. without large-balloon dilation for the removal of large bile duct stones: Randomized multicenter study. Endoscopy 49, 968–976 (2017).
doi: 10.1055/s-0043-114411 pubmed: 28753698
Itoi, T. et al. Endoscopic sphincterotomy combined with large balloon dilation can reduce the procedure time and fluoroscopy time for removal of large bile duct stones. Am. J. Gastroenterol. 104, 560–565 (2009).
pubmed: 19174779
Kuo, C. M. et al. Endoscopic papillary balloon dilation for removal of bile duct stones: Evaluation of outcomes and complications in 298 patients. J. Clin. Gastroenterol. 46, 860–864 (2012).
doi: 10.1097/MCG.0b013e3182617a42 pubmed: 23060218
Sakai, Y. et al. Comparison of endoscopic papillary balloon dilatation and endoscopic sphincterotomy for bile duct stones. World J. Gastrointest. Endosc. 8, 395–401 (2016).
doi: 10.4253/wjge.v8.i10.395 pubmed: 27247706 pmcid: 4877531
Fujisawa, T. et al. Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis?. World J. Gastroenterol. 22, 5909 (2016).
doi: 10.3748/wjg.v22.i26.5909 pubmed: 27468185 pmcid: 4948272
Kuzu, U. B. et al. Management of suspected common bile duct stone: Diagnostic yield of current guidelines. HPB 19, 126–132 (2017).
doi: 10.1016/j.hpb.2016.11.003 pubmed: 27914763
Hwang, J. C. et al. Endoscopic large-balloon dilation alone versus endoscopic sphincterotomy plus large-balloon dilation for the treatment of large bile duct stones. BMC Gastroenterol. 13, 15 (2013).
doi: 10.1186/1471-230X-13-15 pubmed: 23324454 pmcid: 3556067
Kim, T. H. et al. International consensus guidelines for endoscopic papillary large-balloon dilation. Gastrointest. Endosc. 83, 37–47 (2016).
doi: 10.1016/j.gie.2015.06.016 pubmed: 26232360
Liao, W. C. et al. Randomized trial of 1-minute versus 5-minute endoscopic balloon dilation for extraction of bile duct stones. Gastrointest. Endosc. 72, 1154–1162 (2010).
doi: 10.1016/j.gie.2010.07.009 pubmed: 20869710
Bang, B. W. et al. The ballooning time in endoscopic papillary balloon dilation for the treatment of bile duct stones. Korean J. Intern. Med. 25, 239–245 (2010).
doi: 10.3904/kjim.2010.25.3.239 pubmed: 20830219 pmcid: 2932935
Paspatis, G. A. et al. Sixty- versus thirty-seconds papillary balloon dilation after sphincterotomy for the treatment of large bile duct stones: A randomized controlled trial. Digest. Liver Dis. 45, 301–304 (2013).
doi: 10.1016/j.dld.2012.10.015
Hakuta, R. et al. Multicenter retrospective and comparative study of 5-minute versus 15-second endoscopic papillary balloon dilation for removal of bile duct stones. Endosc. Int. Open 5, E1027–E1034 (2017).
doi: 10.1055/s-0043-118479 pubmed: 29090241 pmcid: 5658216
Kim, H. W. et al. Limited endoscopic sphincterotomy plus large balloon dilation for choledocholithiasis with periampullary diverticula. World J. Gastroenterol. 16, 4335–4340 (2010).
doi: 10.3748/wjg.v16.i34.4335 pubmed: 20818818 pmcid: 2937115
Tomoda, T. et al. Combination of diclofenac and sublingual nitrates is superior to diclofenac alone in preventing pancreatitis after endoscopic retrograde cholangiopancreatography. Gastroenterology. 156, 1753-1760.e1751 (2019).
doi: 10.1053/j.gastro.2019.01.267 pubmed: 30772342
Shavakhi, A., Minakari, M., Ardestani, M. H., Sadeghizadeh, A. & Shavakhi, S. A comparative study of one minute versus five seconds endoscopic biliary balloon dilation after small sphincterotomy in choleducolithiasis. Adv. Biomed. Res. 4, 28 (2015).
doi: 10.4103/2277-9175.150421 pubmed: 25709993 pmcid: 4333434
Meng, W. et al. Optimal dilation time for combined small endoscopic sphincterotomy and balloon dilation for common bile duct stones: A multicentre, single-blinded, randomised controlled trial. Lancet Gastroenterol. Hepatol. 4, 425–434 (2019).
doi: 10.1016/S2468-1253(19)30075-5 pubmed: 31003961
Lin, C.-K. et al. Endoscopic balloon dilatation is a safe method in the management of common bile duct stones. Dig. Liver Dis. 36, 68–72 (2004).
doi: 10.1016/j.dld.2003.09.014 pubmed: 14971818
Omar, M. A. et al. Endoscopic papillary large balloon dilation versus endoscopic sphincterotomy for retrieval of large choledocholithiasis: A prospective randomized trial. J. Laparoendosc. Adv. Surg. Tech. A. 27, 704–709 (2017).
doi: 10.1089/lap.2016.0601 pubmed: 28402704
Sato, H. et al. Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: Evaluation from the viewpoint of endoscopic manometry. Gut. 41, 541–544 (1997).
doi: 10.1136/gut.41.4.541 pubmed: 9391256 pmcid: 1891512
Cheon, Y. K., Lee, T. Y., Kim, S. N. & Shim, C. S. Impact of endoscopic papillary large-balloon dilation on sphincter of Oddi function: A prospective randomized study. Gastrointest. Endosc. 85, 782-790.e781 (2017).
doi: 10.1016/j.gie.2016.08.031 pubmed: 27597425
Park, C. H. et al. Comparative efficacy of various endoscopic techniques for the treatment of common bile duct stones: A network meta-analysis. Gastrointest. Endosc. 87, 43-57.e10 (2018).
doi: 10.1016/j.gie.2017.07.038 pubmed: 28756105
Wang, A. Y. Reappraisal of endoscopic papillary balloon dilation versus sphincterotomy for choledocholithiasis—time for a new trial. Clin. Gastroenterol. Hepatol. 15, 1671–1673 (2017).
doi: 10.1016/j.cgh.2017.07.038 pubmed: 28782671
Williams, E. J. et al. Risk factors for complication following ERCP; results of a large-scale, prospective multicenter study. Endoscopy. 39, 793–801 (2007).
doi: 10.1055/s-2007-966723 pubmed: 17703388
Lin, Y. et al. Analysis of risk factors and prevention strategies of post-ERCP pancreatitis. Eur. Rev. Med. Pharmacol. Sci. 21, 5185–5190 (2017).
pubmed: 29228432
Feng, Y. et al. Comparison of endoscopic papillary large balloon dilation and endoscopic sphincterotomy for retrieval of choledocholithiasis: A meta-analysis of randomized controlled trials. J. Gastroenterol. 47, 655–663 (2012).
doi: 10.1007/s00535-012-0528-9 pubmed: 22361862
Stefanidis, G. et al. Large balloon dilation vs. mechanical lithotripsy for the management of large bile duct stones: A prospective randomized study. Am. J. Gastroenterol. 106, 278–285 (2011).
doi: 10.1038/ajg.2010.421 pubmed: 21045816
Nakai, Y. et al. Risk factors for post-ERCP pancreatitis in wire-guided cannulation for therapeutic biliary ERCP. Gastrointest. Endosc. 81, 119–126 (2015).
doi: 10.1016/j.gie.2014.06.005 pubmed: 25442080
Dumonceau, J. M. et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 52, 127–149 (2020).
doi: 10.1055/a-1075-4080 pubmed: 31863440

Auteurs

Yuan-Yuan Li (YY)

Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.

Yin-Shui Miao (YS)

Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.

Cai-Feng Wang (CF)

Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.

Jing Yan (J)

Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.

Xiao-Jiang Zhou (XJ)

Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.

You-Xiang Chen (YX)

Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.

Guo-Hua Li (GH)

Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China. liguohua98@sohu.com.

Liang Zhu (L)

Department of Gastroenterology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China. 89493075@qq.com.

Classifications MeSH