Large-diameter biliary orifice balloon dilation to aid in endoscopic bile duct stone removal: a multicenter series

Siriboon Attasaranya, Young Koog Cheon, Harsha Vittal, Douglas A. Howell, Donald E. Wakelin, John T Cunningham, Niraj Ajmere, Ronald W. Ste Marie, Kanishka Bhattacharya, Kapil Gupta, Martin L. Freeman, Stuart Sherman, Lee McHenry, James L. Watkins, Evan L. Fogel, Suzette Schmidt, Glen A. Lehman

Research output: Contribution to journalArticle

143 Citations (Scopus)

Abstract

Background: The utility and safety of endoscopic biliary orifice balloon dilation (EBD) for bile duct stone removal (with use of large-diameter balloons) after biliary endoscopic sphincterotomy (BES) is currently not well established. Objective: Our purpose was to evaluate the efficacy and complications of BES followed by ≥12 mm diameter EBD for bile duct stone removal. Design: Retrospective, multicenter series. Setting: Five ERCP referral centers in the United States. Patients and Interventions: Patients who underwent attempted removal of bile duct stones by BES followed by EBD with ≥12 mm diameter dilating balloons were identified by searching the prospectively recorded endoscopic databases from 1999 to 2007. Clinical parameters, endoscopic data, and outcomes were collected and analyzed. Results: One hundred three patients, mean age 70 ± 17 years (range 23-98 years), with 56 (54%) women, underwent 107 procedures. Eleven patients (11%) had a prior history of acute pancreatitis. Pancreatogram was performed in 15 (14%) patients. Median stone size and median balloon diameter used was 13 mm. Complete stone removal in the first session of EBD was accomplished in 102 (95%) procedures, and mechanical lithotripsy was required in 29 (27%). Six patients (5.4%) had documented procedure-related complications including one patient with severe bleeding and one with severe cystic duct perforation. No acute pancreatitis occurred. Conclusion: EBD with a large-diameter balloon in conjunction with BES for bile duct stone removal is effective and relatively safe. This technique appears to be a reasonable alternative option when standard BES and basket or balloon sweep are inadequate to remove bile duct stones.

Original languageEnglish (US)
Pages (from-to)1046-1052
Number of pages7
JournalGastrointestinal Endoscopy
Volume67
Issue number7
DOIs
StatePublished - Jun 2008
Externally publishedYes

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Bile Ducts
Endoscopic Sphincterotomy
Dilatation
Pancreatitis
Cystic Duct
Lithotripsy
Endoscopic Retrograde Cholangiopancreatography
Referral and Consultation
Databases
Hemorrhage
Safety

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Large-diameter biliary orifice balloon dilation to aid in endoscopic bile duct stone removal : a multicenter series. / Attasaranya, Siriboon; Cheon, Young Koog; Vittal, Harsha; Howell, Douglas A.; Wakelin, Donald E.; Cunningham, John T; Ajmere, Niraj; Ste Marie, Ronald W.; Bhattacharya, Kanishka; Gupta, Kapil; Freeman, Martin L.; Sherman, Stuart; McHenry, Lee; Watkins, James L.; Fogel, Evan L.; Schmidt, Suzette; Lehman, Glen A.

In: Gastrointestinal Endoscopy, Vol. 67, No. 7, 06.2008, p. 1046-1052.

Research output: Contribution to journalArticle

Attasaranya, S, Cheon, YK, Vittal, H, Howell, DA, Wakelin, DE, Cunningham, JT, Ajmere, N, Ste Marie, RW, Bhattacharya, K, Gupta, K, Freeman, ML, Sherman, S, McHenry, L, Watkins, JL, Fogel, EL, Schmidt, S & Lehman, GA 2008, 'Large-diameter biliary orifice balloon dilation to aid in endoscopic bile duct stone removal: a multicenter series', Gastrointestinal Endoscopy, vol. 67, no. 7, pp. 1046-1052. https://doi.org/10.1016/j.gie.2007.08.047
Attasaranya, Siriboon ; Cheon, Young Koog ; Vittal, Harsha ; Howell, Douglas A. ; Wakelin, Donald E. ; Cunningham, John T ; Ajmere, Niraj ; Ste Marie, Ronald W. ; Bhattacharya, Kanishka ; Gupta, Kapil ; Freeman, Martin L. ; Sherman, Stuart ; McHenry, Lee ; Watkins, James L. ; Fogel, Evan L. ; Schmidt, Suzette ; Lehman, Glen A. / Large-diameter biliary orifice balloon dilation to aid in endoscopic bile duct stone removal : a multicenter series. In: Gastrointestinal Endoscopy. 2008 ; Vol. 67, No. 7. pp. 1046-1052.
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abstract = "Background: The utility and safety of endoscopic biliary orifice balloon dilation (EBD) for bile duct stone removal (with use of large-diameter balloons) after biliary endoscopic sphincterotomy (BES) is currently not well established. Objective: Our purpose was to evaluate the efficacy and complications of BES followed by ≥12 mm diameter EBD for bile duct stone removal. Design: Retrospective, multicenter series. Setting: Five ERCP referral centers in the United States. Patients and Interventions: Patients who underwent attempted removal of bile duct stones by BES followed by EBD with ≥12 mm diameter dilating balloons were identified by searching the prospectively recorded endoscopic databases from 1999 to 2007. Clinical parameters, endoscopic data, and outcomes were collected and analyzed. Results: One hundred three patients, mean age 70 ± 17 years (range 23-98 years), with 56 (54{\%}) women, underwent 107 procedures. Eleven patients (11{\%}) had a prior history of acute pancreatitis. Pancreatogram was performed in 15 (14{\%}) patients. Median stone size and median balloon diameter used was 13 mm. Complete stone removal in the first session of EBD was accomplished in 102 (95{\%}) procedures, and mechanical lithotripsy was required in 29 (27{\%}). Six patients (5.4{\%}) had documented procedure-related complications including one patient with severe bleeding and one with severe cystic duct perforation. No acute pancreatitis occurred. Conclusion: EBD with a large-diameter balloon in conjunction with BES for bile duct stone removal is effective and relatively safe. This technique appears to be a reasonable alternative option when standard BES and basket or balloon sweep are inadequate to remove bile duct stones.",
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T1 - Large-diameter biliary orifice balloon dilation to aid in endoscopic bile duct stone removal

T2 - a multicenter series

AU - Attasaranya, Siriboon

AU - Cheon, Young Koog

AU - Vittal, Harsha

AU - Howell, Douglas A.

AU - Wakelin, Donald E.

AU - Cunningham, John T

AU - Ajmere, Niraj

AU - Ste Marie, Ronald W.

AU - Bhattacharya, Kanishka

AU - Gupta, Kapil

AU - Freeman, Martin L.

AU - Sherman, Stuart

AU - McHenry, Lee

AU - Watkins, James L.

AU - Fogel, Evan L.

AU - Schmidt, Suzette

AU - Lehman, Glen A.

PY - 2008/6

Y1 - 2008/6

N2 - Background: The utility and safety of endoscopic biliary orifice balloon dilation (EBD) for bile duct stone removal (with use of large-diameter balloons) after biliary endoscopic sphincterotomy (BES) is currently not well established. Objective: Our purpose was to evaluate the efficacy and complications of BES followed by ≥12 mm diameter EBD for bile duct stone removal. Design: Retrospective, multicenter series. Setting: Five ERCP referral centers in the United States. Patients and Interventions: Patients who underwent attempted removal of bile duct stones by BES followed by EBD with ≥12 mm diameter dilating balloons were identified by searching the prospectively recorded endoscopic databases from 1999 to 2007. Clinical parameters, endoscopic data, and outcomes were collected and analyzed. Results: One hundred three patients, mean age 70 ± 17 years (range 23-98 years), with 56 (54%) women, underwent 107 procedures. Eleven patients (11%) had a prior history of acute pancreatitis. Pancreatogram was performed in 15 (14%) patients. Median stone size and median balloon diameter used was 13 mm. Complete stone removal in the first session of EBD was accomplished in 102 (95%) procedures, and mechanical lithotripsy was required in 29 (27%). Six patients (5.4%) had documented procedure-related complications including one patient with severe bleeding and one with severe cystic duct perforation. No acute pancreatitis occurred. Conclusion: EBD with a large-diameter balloon in conjunction with BES for bile duct stone removal is effective and relatively safe. This technique appears to be a reasonable alternative option when standard BES and basket or balloon sweep are inadequate to remove bile duct stones.

AB - Background: The utility and safety of endoscopic biliary orifice balloon dilation (EBD) for bile duct stone removal (with use of large-diameter balloons) after biliary endoscopic sphincterotomy (BES) is currently not well established. Objective: Our purpose was to evaluate the efficacy and complications of BES followed by ≥12 mm diameter EBD for bile duct stone removal. Design: Retrospective, multicenter series. Setting: Five ERCP referral centers in the United States. Patients and Interventions: Patients who underwent attempted removal of bile duct stones by BES followed by EBD with ≥12 mm diameter dilating balloons were identified by searching the prospectively recorded endoscopic databases from 1999 to 2007. Clinical parameters, endoscopic data, and outcomes were collected and analyzed. Results: One hundred three patients, mean age 70 ± 17 years (range 23-98 years), with 56 (54%) women, underwent 107 procedures. Eleven patients (11%) had a prior history of acute pancreatitis. Pancreatogram was performed in 15 (14%) patients. Median stone size and median balloon diameter used was 13 mm. Complete stone removal in the first session of EBD was accomplished in 102 (95%) procedures, and mechanical lithotripsy was required in 29 (27%). Six patients (5.4%) had documented procedure-related complications including one patient with severe bleeding and one with severe cystic duct perforation. No acute pancreatitis occurred. Conclusion: EBD with a large-diameter balloon in conjunction with BES for bile duct stone removal is effective and relatively safe. This technique appears to be a reasonable alternative option when standard BES and basket or balloon sweep are inadequate to remove bile duct stones.

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