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What is an appropriate indication for endoscopic papillary balloon dilation?
Masaaki Natsui1, Rintaro Narisawa, Hirotaka Motoyama
1Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, Japan.
European Journal of Gastroenterology & Hepatology
|June 20, 2002
Summary
Endoscopic papillary balloon dilation (EPBD) and endoscopic sphincterotomy (EST) are effective for small bile duct stones. EPBD required more sessions for larger stones, with similar complication risks.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Biliary tract interventions
Background:
- Endoscopic papillary balloon dilation (EPBD) and endoscopic sphincterotomy (EST) are common treatments for bile duct stones.
- Indications for EPBD versus EST remain debated.
- This study compares the efficacy and safety of EPBD and EST.
Purpose of the Study:
- To evaluate the efficacy and safety of EPBD compared to EST for managing bile duct stones.
- To determine if stone size influences treatment outcomes.
Main Methods:
- Prospective randomized trial conducted in one university and one general hospital.
- 140 patients were randomized to either EPBD or EST.
- Outcomes and complications were monitored for a median of 30 months.
Main Results:
- Both EPBD and EST achieved similar success rates for stones <10 mm.
- EPBD required significantly more sessions for stones ≥10 mm compared to EST (2.4 vs 1.6, P < 0.01).
- Early and late complication rates were similar between EPBD and EST groups.
Conclusions:
- EPBD demonstrates a low risk of bleeding and comparable efficacy to EST for small bile duct stones.
- Both procedures have similar risks of pancreatitis and recurrent bile duct stones.
- EPBD and EST are appropriate for small bile duct stones; long-term studies are needed for EPBD's established role.