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Long-Term Outcomes After Endoscopic Papillary Large Balloon Dilation With Endoscopic Sphincterotomy for Difficult
Aurelio Mauro1, Evgenija Lozova2, Giuseppe Vanella3
1Gastroenterology and Digestive Endoscopy Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Summary
Endoscopic papillary large balloon dilation (EPLBD) can lead to cholangitis and biliary recurrence, with risks increasing over time. Previous ERCP procedures independently raise the risk of these complications after EPLBD.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Biliary tract diseases
Background:
- Endoscopic papillary large balloon dilation (EPLBD) is a primary treatment for difficult biliary stones.
- EPLBD may impair sphincter of Oddi function, increasing cholangitis risk.
- Long-term data on EPLBD complications are limited.
Purpose of the Study:
- To investigate long-term complications of EPLBD with endoscopic sphincterotomy (ES).
- To assess the rates of cholangitis and biliary recurrence after EPLBD.
- To identify risk factors for post-EPLBD complications.
Main Methods:
- Retrospective study of adult patients undergoing EPLBD with ES.
- Complete bile duct stone clearance was required for inclusion.
- Primary outcome: cholangitis rate; Secondary outcome: biliary recurrence rate.
Main Results:
- 1221 patients included; 11.7% experienced cholangitis.
- Cumulative 5-year risk of cholangitis was 15.3%.
- Cumulative 5-year risk of biliary recurrence was 21.8%; ≥2 prior ERCPs increased risk.
Conclusions:
- Cholangitis and biliary recurrence are significant complications post-EPLBD.
- Sphincter of Oddi dysfunction may contribute to recurrence.
- Further research needed to compare EPLBD with ES to other treatments for long-term outcomes.
