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Balloons larger than 15 mm can increase the risk of adverse events following endoscopic papillary large balloon dilation
Author(s) -
Lee Gil Ho,
Yang Min Jae,
Kim Jin Hong,
Hwang Jae Chul,
Yoo Byung Moo,
Lee Dong Ki,
Jang Sung Ill,
Lee Tae Hoon,
Park SangHeum,
Park JinSeok,
Jeong Seok,
Lee Don Haeng
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14749
Subject(s) - medicine , balloon dilation , bile duct , lithotripsy , adverse effect , perforation , odds ratio , surgery , common bile duct , balloon , materials science , punching , metallurgy
Background and Aim Although endoscopic papillary large balloon dilation (EPLBD) has been widely used to facilitate the removal of difficult common bile duct stones, however, the outcomes have not yet been investigated in terms of the diameter of the balloon used. We aimed to compare the clinical outcomes between EPLBD using smaller (12–15 mm, S‐EPLBD) and larger balloons (> 15 mm, L‐EPLBD). Methods Six hundred seventy‐two patients who underwent EPLBD with or without endoscopic sphincterotomy for common bile duct stone removal were enrolled from May 2004 to August 2014 at four tertiary referral centers in Korea. The outcomes, including the initial success rate, the success rate without endoscopic mechanical lithotripsy, the overall success rate, and adverse events between S‐EPLBD and L‐EPLBD groups, were retrospectively compared. Results The initial success rate, the success rate without mechanical lithotripsy, the overall success rate, and the overall adverse events were not significantly different between the two groups. The rate of severe‐to‐fatal adverse events was higher in the L‐EPBLD group than in the S‐EPLBD group (1.6% vs 0.0%, 0.020). One case of severe bleeding and two cases of fatal perforation occurred only in the L‐EPLBD group. In the multivariate analysis, the use of a > 15‐mm balloon was the only significant risk factor for severe‐to‐fatal adverse events (>0.005, 23.8 [adjusted odds ratio], 2.6–214.4 [95% confidence interval]). Conclusions L‐EPLBD is significantly related to severe‐to‐fatal adverse events compared with S‐EPLBD for common bile duct stone removal.