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Endoscopic Papillary Large Balloon Dilation for Treatment of Large Bile Duct Stones Does Not Increase the Risk of Post-procedure Pancreatitis

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Abstract

Background and Aims

Endoscopic sphincterotomy (ES) and endoscopic papillary large balloon dilation (EPLBD) are well-known procedures for the treatment of common duct stones. There was no statistically significant difference in post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis rates between ES and EPLBD in most studies. The aims of this study were to evaluate whether EPLBD increases the risk of post-ERCP pancreatitis and to identify the risk factors influencing post-ERCP pancreatitis.

Methods

A review of 341 patients who underwent ERCP for treatment of common duct stones larger than 1 cm in diameter from January 2006 to December 2011 was conducted retrospectively. Patients were divided into three groups: ES group (n = 207), EPLBD + ES group (n = 99), and EPLBD with previous history of ES group (n = 35).

Results

Of 341 patients, overall incidence of post-ERCP pancreatitis was 2.6 % (n = 9). Incidence of post-ERCP pancreatitis was 3.4, 2.0, and 0 % in the ES group, EPLBD + ES group, and EPLBD with previous history of ES group, respectively. No significant difference in the incidence of post-ERCP pancreatitis was observed among the three groups (p = 0.47). Endoscopic biliary stenting was the independent risk factor for pancreatitis according to univariate (p = 0.046) and multivariate analyses (p = 0.036, OR 4.211, 95 % CI 1.095–16.199). Age, sex, stone size, mechanical lithotripsy, common bile duct diameter, balloon size, and duration of balloon dilation were not significantly related to post-ERCP pancreatitis.

Conclusion

EPLBD with antecedent limited ES or previous ES state does not increase the risk of post-ERCP pancreatitis in patients with large bile duct stones. Endoscopic biliary stenting seems to be the independent risk factor of post-ERCP pancreatitis.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung 5-dong, Nam-gu, Daegu, Korea

    Jun Suk Park, Tae Nyeun Kim & Kook Hyun Kim

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  1. Jun Suk Park
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  2. Tae Nyeun Kim
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  3. Kook Hyun Kim
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Correspondence to Tae Nyeun Kim.

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Park, J.S., Kim, T.N. & Kim, K.H. Endoscopic Papillary Large Balloon Dilation for Treatment of Large Bile Duct Stones Does Not Increase the Risk of Post-procedure Pancreatitis. Dig Dis Sci 59, 3092–3098 (2014). https://doi.org/10.1007/s10620-014-3259-3

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  • DOI: https://doi.org/10.1007/s10620-014-3259-3

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