Balloons larger than 15 mm can increase the risk of adverse events following endoscopic papillary large balloon dilation

Gil Ho Lee, Min Jae Yang, Jin Hong Kim, Jae Chul Hwang, Byung Moo Yoo, Dong Ki Lee, Sung Ill Jang, Tae Hoon Lee, Sang Heum Park, Jin Seok Park, Seok Jeong, Don Haeng Lee

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)1450-1453
Number of pages4
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume34
Issue number8
DOIs
Publication statusPublished - 2019 Jan 1

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Dilatation
Common Bile Duct
Lithotripsy
Endoscopic Sphincterotomy
Korea
Tertiary Care Centers
Multivariate Analysis
Odds Ratio
Confidence Intervals
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

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, Sang Heum ; Park, Jin Seok ; Jeong, Seok ; Lee, Don Haeng. / Balloons larger than 15 mm can increase the risk of adverse events following endoscopic papillary large balloon dilation. In: Journal of Gastroenterology and Hepatology (Australia). 2019 ; Vol. 34, No. 8. pp. 1450-1453.
@article{8ef75b992095425ab809517198041a4a,
title = "Balloons larger than 15 mm can increase the risk of adverse events following endoscopic papillary large balloon dilation",
abstract = "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.",
author = "Lee, {Gil Ho} and Yang, {Min Jae} and Kim, {Jin Hong} and Hwang, {Jae Chul} and Yoo, {Byung Moo} and Lee, {Dong Ki} and Jang, {Sung Ill} and Lee, {Tae Hoon} and Park, {Sang Heum} and Park, {Jin Seok} and Seok Jeong and Lee, {Don Haeng}",
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Lee, GH, Yang, MJ, Kim, JH, Hwang, JC, Yoo, BM, Lee, DK, Jang, SI, Lee, TH, Park, SH, Park, JS, Jeong, S & Lee, DH 2019, 'Balloons larger than 15 mm can increase the risk of adverse events following endoscopic papillary large balloon dilation', Journal of Gastroenterology and Hepatology (Australia), vol. 34, no. 8, pp. 1450-1453. https://doi.org/10.1111/jgh.14749

Balloons larger than 15 mm can increase the risk of adverse events following endoscopic papillary large balloon dilation. / 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, Sang Heum; Park, Jin Seok; Jeong, Seok; Lee, Don Haeng.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 34, No. 8, 01.01.2019, p. 1450-1453.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Balloons larger than 15 mm can increase the risk of adverse events following endoscopic papillary large balloon dilation

AU - Lee, Gil Ho

AU - Yang, Min Jae

AU - Kim, Jin Hong

AU - Hwang, Jae Chul

AU - Yoo, Byung Moo

AU - Lee, Dong Ki

AU - Jang, Sung Ill

AU - Lee, Tae Hoon

AU - Park, Sang Heum

AU - Park, Jin Seok

AU - Jeong, Seok

AU - Lee, Don Haeng

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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DO - 10.1111/jgh.14749

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