Balloon Dilation Itself May Not Be a Major Determinant of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2014 Dec 11

PMID 25493004

Citations 3

Authors

Sung Ill Jang

Gak Won Yun

Dong Ki Lee

Affiliations

Soon will be listed here.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is the essential first modality for common bile duct (CBD) stone therapy. The conventional endoscopic treatment for CBD stones is stone removal after endoscopic sphincterotomy (EST). Stone removal after papillary stretching using balloon dilation instead of the conventional method has been widely adopted. There are many reports regarding endoscopic papillary balloon dilation (EPBD) utilizing a small balloon (< 10 mm) instead of EST for the removal of small CBD stones. In contrast, two cases of mortality due to post-ERCP pancreatitis (PEP) were reported after an EPBD clinical trial in the Western world, and the psychological barrier caused by these incidences hinders the use of this technique in Western countries. Endoscopic papillar large balloon dilation (EPLBD), which is used to treat large CBD stones, was not widely adopted when first introduced due to concerns about perforation and severe pancreatitis from the use of a large balloon (12-20 mm). However, as experience with this procedure accumulates, the occurrence of PEP with EPLBD is confirmed to be much lower than with EPBD. This report reviews whether EPBD and EPLBD, two procedures that use balloon dilation but differ in terms of indications and concept, contribute to the occurrence of PEP.

Citing Articles

Case Series of Endoscopic Papillary Balloon Dilation for Children with Common Bile Duct Stones and a Review of the Literature.

Kouchi K, Takenouchi A, Matsuoka A, Yabe K, Yoshizawa H, Nakata C J Clin Med. 2024; 13(8).

PMID: 38673524 PMC: 11050672. DOI: 10.3390/jcm13082251.

Prognostic Factors for Severe-to-Fatal Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Multicenter Prospective Cohort Study.

Matsumoto K, Noma H, Fujita K, Tomoda T, Onoyama T, Hanada K J Clin Med. 2024; 13(4).

PMID: 38398448 PMC: 10889235. DOI: 10.3390/jcm13041135.

Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis?.

Fujisawa T, Kagawa K, Hisatomi K, Kubota K, Nakajima A, Matsuhashi N World J Gastroenterol. 2016; 22(26):5909-16.

PMID: 27468185 PMC: 4948272. DOI: 10.3748/wjg.v22.i26.5909.

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