PMID- 12072597
OWN - NLM
STAT- MEDLINE
DCOM- 20020906
LR  - 20190906
IS  - 0954-691X (Print)
IS  - 0954-691X (Linking)
VI  - 14
IP  - 6
DP  - 2002 Jun
TI  - What is an appropriate indication for endoscopic papillary balloon dilation?
PG  - 635-40
AB  - OBJECTIVE: There are a number of views on the indication for endoscopic papillary 
      balloon dilation (EPBD) in the management of bile duct stones. In this study, we 
      have evaluated the efficacy and safety of EPBD compared with endoscopic 
      sphincterotomy (EST). DESIGN: Prospective randomized trial. SETTING: One 
      university hospital and one general hospital. PARTICIPANTS AND MAIN OUTCOME 
      MEASURES: One hundred and forty patients were randomly allocated to EPBD or EST. 
      Outcomes and complications were observed for a median period of 30 months. 
      RESULTS: Both treatment approaches finally achieved similar success rates and 
      needed similar numbers of treatment sessions for patients with stones less than 
      10 mm in diameter. However, for patients with stones of 10 mm or more, EPBD 
      required a significantly greater mean number of treatment sessions than EST (2.4 
      vs 1.6, P < 0.01). Early complications occurred in seven EPBD (four pancreatitis, 
      two cholangitis and one basket impaction) and eight EST (three pancreatitis, two 
      bleeding and three cholangitis) patients. Late complications occurred in four 
      EPBD (three recurrent bile duct stones and one cholecystitis) and six EST (three 
      recurrent stones and three cholecystitis) patients. CONCLUSIONS: EPBD has little 
      risk of bleeding. The technique removed small bile duct stones just as easily as 
      did EST. These two procedures had approximately the same risk of pancreatitis and 
      incidence of recurrent bile duct stones. Therefore, both procedures appear to be 
      appropriate treatments for small bile duct stones. Whether or not EPBD becomes an 
      established treatment will depend on further long-term studies.
FAU - Natsui, Masaaki
AU  - Natsui M
AD  - Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, 
      Japan.
FAU - Narisawa, Rintaro
AU  - Narisawa R
FAU - Motoyama, Hirotaka
AU  - Motoyama H
FAU - Hayashi, Shun-Ichi
AU  - Hayashi S
FAU - Seki, Keiichi
AU  - Seki K
FAU - Wakabayashi, Hiroto
AU  - Wakabayashi H
FAU - Itoh, Shin-Ichi
AU  - Itoh S
FAU - Asakura, Hitoshi
AU  - Asakura H
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - England
TA  - Eur J Gastroenterol Hepatol
JT  - European journal of gastroenterology & hepatology
JID - 9000874
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Ampulla of Vater
MH  - *Catheterization/adverse effects/methods
MH  - Cholecystitis/etiology
MH  - Cholelithiasis/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreatitis/etiology
MH  - Prospective Studies
MH  - Recurrence
MH  - Safety
MH  - Sphincterotomy, Endoscopic/adverse effects
MH  - Treatment Outcome
EDAT- 2002/06/20 10:00
MHDA- 2002/09/07 10:01
CRDT- 2002/06/20 10:00
PHST- 2002/06/20 10:00 [pubmed]
PHST- 2002/09/07 10:01 [medline]
PHST- 2002/06/20 10:00 [entrez]
AID - 10.1097/00042737-200206000-00008 [doi]
PST - ppublish
SO  - Eur J Gastroenterol Hepatol. 2002 Jun;14(6):635-40. doi: 
      10.1097/00042737-200206000-00008.