3 147

Factors Predictive of Adverse Events Following Endoscopic Papillary Large Balloon Dilation: Results from a Multicenter Series

Authors
 Soo Jung Park  ;  Jin Hong Kim  ;  Jae Chul Hwang  ;  Ho Gak Kim  ;  Don Haeng Lee  ;  Seok Jeong  ;  Sang-Woo Cha  ;  Young Deok Cho  ;  Hong Ja Kim  ;  Jong Hyeok Kim  ;  Jong Ho Moon  ;  Sang-Heum Park  ;  Takao Itoi  ;  Hiroyuki Isayama  ;  Hirofumi Kogure  ;  Se Joon Lee  ;  Kyo Tae Jung  ;  Hye Sun Lee  ;  Todd H. Baron  ;  Dong Ki Lee 
Citation
 Digestive Diseases and Sciences, Vol.58(4) : 1100-1109, 2013 
Journal Title
 Digestive Diseases and Sciences 
ISSN
 0163-2116 
Issue Date
2013
Abstract
BACKGROUND: Lack of established guidelines for endoscopic papillary large balloon dilation (EPLBD) may be a reason for aversion of its use in removal of large common bile duct (CBD) stones. AIMS: We sought to identify factors predictive of adverse events (AEs) following EPLBD. METHODS: This multicenter retrospective study investigated 946 consecutive patients who underwent attempted removal of CBD stones ≥10 mm in size using EPLBD (balloon size 12-20 mm) with or without endoscopic sphincterotomy (EST) at 12 academic medical centers in Korea and Japan. RESULTS: Ninety-five (10.0 %) patients exhibited AEs including bleeding in 56, pancreatitis in 24, perforation in nine, and cholangitis in six; 90 (94.7 %) of these were classified as mild or moderate in severity. There were four deaths, three as a result of perforation and one due to delayed massive bleeding. Causative factors identified in fatal cases were full-EST and continued balloon inflation despite a persistent waist seen fluoroscopically. Multivariate analyses showed that cirrhosis (OR 8.03, p = 0.003), length of EST (full-EST: OR 6.22, p < 0.001) and stone size (≥16 mm: OR 4.00, p < 0.001) were associated with increased bleeding, and distal CBD stricture (OR 17.08, p < 0.001) was an independent predictor for perforation. On the other hand, balloon size was associated with deceased pancreatitis (≥14 mm: OR 0.27, p = 0.015). CONCLUSIONS: EPLBD appears to be a safe and effective therapeutic approach for retrieval of large stones in patients without distal CBD strictures and when performed without full-EST.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86676
Full Text
http://link.springer.com/article/10.1007%2Fs10620-012-2494-8
DOI
10.1007/s10620-012-2494-8
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
박수정(Park, Soo Jung)
이동기(Lee, Dong Ki) ORCID logo https://orcid.org/0000-0002-0048-9112
이세준(Lee, Se Joon)
정교태(Jung, Kyo Tae)
Export
RIS (EndNote)
XLS (Excel)
XML
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse