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Endoscopic papillary balloon dilation for bile duct stone removal in patients 60 years old or younger

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

The aim of this study was to evaluate short- and long-term outcomes in relatively young patients (≤60 years old) who underwent endoscopic papillary balloon dilation (EPBD) for bile duct stone removal.

Methods

Immediate and long-term outcomes were evaluated in 311 patients who were 60 years old or younger at the time of EPBD. The stone recurrence rate was compared among four groups stratified according to gallbladder (GB) status before and after EPBD (cholecystectomy after EPBD, GB left in situ with stones, GB left in situ without stones, and cholecystectomy before EPBD).

Results

Bile duct stones were completely removed via EPBD alone in 304 patients (97.7%). Post-EPBD pancreatitis occurred in 24 patients (7.7%), and was mild in 18 patients, moderate in 5 patients, and severe in 1 patient. The rate of pancreatitis was significantly higher in these patients than in patients aged more than 60 years who underwent EPBD during the same study period (4.7%). Long-term outcomes were evaluated in 217 patients who were followed for at least 1 year after complete stone removal via EPBD. During a mean follow-up period of 5.6 years (range, 1.0–13.4 years), stone recurrence was observed in 13 patients (6.0%). The cumulative stone recurrence rates at 5 and 10 years after EPBD were 5.9 and 7.1%, respectively. Patients in the cholecystectomy after EPBD group had the lowest risk of stone recurrence among the four groups (2.0%).

Conclusion

EPBD removes bile duct stones in the majority of younger patients without increasing the risk of severe pancreatitis. Post-EPBD pancreatitis is more likely to occur in younger patients as compared to older patients. The long-term outcomes of EPBD appear favorable, especially in patients who have undergone cholecystectomy after EPBD.

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Authors and Affiliations

  1. Department of Gastroenterology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Takeshi Tsujino, Haruhiko Yoshida, Hiroyuki Isayama, Yoko Yashima, Hiroshi Yagioka, Hirofumi Kogure, Takashi Sasaki, Toshihiko Arizumi, Osamu Togawa, Saburo Matsubara, Yousuke Nakai, Naoki Sasahira, Kenji Hirano, Minoru Tada, Masao Omata & Kazuhiko Koike

  2. Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan

    Yukiko Ito

  3. Department of Endoscopy and Endoscopic Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan

    Takao Kawabe

Authors
  1. Takeshi Tsujino
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  2. Haruhiko Yoshida
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  3. Hiroyuki Isayama
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  4. Yukiko Ito
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  16. Takao Kawabe
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Corresponding author

Correspondence to Takeshi Tsujino.

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Tsujino, T., Yoshida, H., Isayama, H. et al. Endoscopic papillary balloon dilation for bile duct stone removal in patients 60 years old or younger. J Gastroenterol 45, 1072–1079 (2010). https://doi.org/10.1007/s00535-010-0254-0

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  • DOI: https://doi.org/10.1007/s00535-010-0254-0

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