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The increase in balloon size to over 15 mm does not affect the development of pancreatitis after endoscopic papillary large balloon dilatation for bile duct stone removal.

 Young Hoon Youn  ;  Hyun Chul Lim  ;  Jae Hoon Jahng  ;  Sung Il Jang  ;  Jung Hwan You  ;  Jung Soo Park  ;  Se Joon Lee  ;  Dong Ki Lee 
 DIGESTIVE DISEASES AND SCIENCES, Vol.56(5) : 1572-1577, 2011 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Bile Duct Diseases/surgery* ; Catheterization/instrumentation* ; Catheterization/methods* ; Gallstones/surgery* ; Humans ; Middle Aged ; Retrospective Studies
Common bile duct (CBD) stone ; Endoscopic papillary large balloon dilatation (EPLBD) ; Large balloon ; Post-EPLBD pancreatitis
BACKGROUND: Endoscopic papillary large balloon dilatation (EPLBD) after endoscopic sphincterotomy (EST) has recently become widely used for common bile duct (CBD) stone removal, but many clinicians remain concerned about post-procedural pancreatitis with increasing the balloon size to over 15 mm.

AIMS: We aimed to evaluate the safety and efficacy of EPLBD with a relatively large balloon (15-20 mm) after EST and to evaluate the factors related to post-EPLBD pancreatitis.

METHODS: A retrospective review was undertaken of the endoscopic database of 101 patients with CBD stones who underwent EPLBD using a larger balloon size of over 15 mm (15-20 mm). Clinical parameters, endoscopic data, and outcomes were analyzed.

RESULTS: The mean age of the subjects was 69 years. All patients had a dilated CBD of over 11 mm (mean = 22.6 mm). The mean size of balloon used in EPLBD was 17.1 ± 1.9 mm (range 15-20 mm). Mechanical lithotripsy was required in seven patients (6.9%). The rate of complete stone removal in the first session was 92.1%. Post-procedural pancreatitis developed in five cases (5.4%), but none were graded as severe. The smaller dilatation of the CBD, longer cannulation time, and longer time for stone removal were associated with post-procedural pancreatitis, but larger size of balloon did not affect the development of post-EPLBD pancreatitis.

CONCLUSIONS: EPLBD with a large balloon of over 15 mm with EST is an effective and safe procedure with a very low probability of severe post-procedural pancreatitis. Post-EPLBD pancreatitis was not associated with larger balloon size, but was associated with longer procedure time and smaller dilatation of the CBD.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Cheong Soo(박정수)
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Lee, Dong Ki(이동기) ORCID logo https://orcid.org/0000-0002-0048-9112
Lee, Se Joon(이세준) ORCID logo https://orcid.org/0000-0002-2695-2670
Lim, Hyun Chul(임현철)
Jang, Sung Ill(장성일) ORCID logo https://orcid.org/0000-0003-4937-6167
Jahng, Jae Hoon(장재훈)
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