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Balloons larger than 15 mm can increase the risk of adverse events following endoscopic papillary large balloon dilation

Authors
 Gil Ho Lee  ;  Min Jae Yang  ;  Jin Hong Kim  ;  Jae Chul Hwang  ;  Byung Moo Yoo  ;  Dong Ki Lee  ;  Sung Ill Jang  ;  Tae Hoon Lee  ;  Sang‐Heum Park  ;  Jin‐Seok Park  ;  Seok Jeong  ;  Don Haeng Lee 
Citation
 Journal of Gastroenterology and Hepatology, Vol.34(8) : 1450-1453, 2019 
Journal Title
 Journal of Gastroenterology and Hepatology 
ISSN
 0815-9319 
Issue Date
2019
Keywords
adverse event ; bile duct stone ; endoscopic papillary large balloon dilation
Abstract
BACKGROUND AND AIM: Although endoscopic papillary large balloon dilation (EPLBD) has been widely used to facilitate the removal of difficult common bile duct stones, however, the outcomes have not yet been investigated in terms of the diameter of the balloon used. We aimed to compare the clinical outcomes between EPLBD using smaller (12-15 mm, S-EPLBD) and larger balloons (> 15 mm, L-EPLBD). METHODS: Six hundred seventy-two patients who underwent EPLBD with or without endoscopic sphincterotomy for common bile duct stone removal were enrolled from May 2004 to August 2014 at four tertiary referral centers in Korea. The outcomes, including the initial success rate, the success rate without endoscopic mechanical lithotripsy, the overall success rate, and adverse events between S-EPLBD and L-EPLBD groups, were retrospectively compared. RESULTS: The initial success rate, the success rate without mechanical lithotripsy, the overall success rate, and the overall adverse events were not significantly different between the two groups. The rate of severe-to-fatal adverse events was higher in the L-EPBLD group than in the S-EPLBD group (1.6% vs 0.0%, 0.020). One case of severe bleeding and two cases of fatal perforation occurred only in the L-EPLBD group. In the multivariate analysis, the use of a > 15-mm balloon was the only significant risk factor for severe-to-fatal adverse events (>0.005, 23.8 [adjusted odds ratio], 2.6-214.4 [95% confidence interval]). CONCLUSIONS: L-EPLBD is significantly related to severe-to-fatal adverse events compared with S-EPLBD for common bile duct stone removal.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/jgh.14749
DOI
10.1111/jgh.14749
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Dong Ki(이동기) ORCID logo https://orcid.org/0000-0002-0048-9112
Jang, Sung Ill(장성일) ORCID logo https://orcid.org/0000-0003-4937-6167
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/171382
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