PMID- 23225136
OWN - NLM
STAT- MEDLINE
DCOM- 20130528
LR  - 20220331
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Linking)
VI  - 58
IP  - 4
DP  - 2013 Apr
TI  - Factors predictive of adverse events following endoscopic papillary large balloon 
      dilation: results from a multicenter series.
PG  - 1100-9
LID - 10.1007/s10620-012-2494-8 [doi]
AB  - BACKGROUND: Lack of established guidelines for endoscopic papillary large balloon 
      dilation (EPLBD) may be a reason for aversion of its use in removal of large 
      common bile duct (CBD) stones. AIMS: We sought to identify factors predictive of 
      adverse events (AEs) following EPLBD. METHODS: This multicenter retrospective 
      study investigated 946 consecutive patients who underwent attempted removal of 
      CBD stones >/=10 mm in size using EPLBD (balloon size 12-20 mm) with or without 
      endoscopic sphincterotomy (EST) at 12 academic medical centers in Korea and 
      Japan. RESULTS: Ninety-five (10.0 %) patients exhibited AEs including bleeding in 
      56, pancreatitis in 24, perforation in nine, and cholangitis in six; 90 (94.7 %) 
      of these were classified as mild or moderate in severity. There were four deaths, 
      three as a result of perforation and one due to delayed massive bleeding. 
      Causative factors identified in fatal cases were full-EST and continued balloon 
      inflation despite a persistent waist seen fluoroscopically. Multivariate analyses 
      showed that cirrhosis (OR 8.03, p = 0.003), length of EST (full-EST: OR 6.22, p < 
      0.001) and stone size (>/=16 mm: OR 4.00, p < 0.001) were associated with increased 
      bleeding, and distal CBD stricture (OR 17.08, p < 0.001) was an independent 
      predictor for perforation. On the other hand, balloon size was associated with 
      deceased pancreatitis (>/=14 mm: OR 0.27, p = 0.015). CONCLUSIONS: EPLBD appears to 
      be a safe and effective therapeutic approach for retrieval of large stones in 
      patients without distal CBD strictures and when performed without full-EST.
FAU - Park, Soo Jung
AU  - Park SJ
AD  - Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance 
      Hospital, Yonsei University College of Medicine, 211 Eonjuro Gangnam-gu, Seoul 
      135-720, Korea.
FAU - Kim, Jin Hong
AU  - Kim JH
FAU - Hwang, Jae Chul
AU  - Hwang JC
FAU - Kim, Ho Gak
AU  - Kim HG
FAU - Lee, Don Haeng
AU  - Lee DH
FAU - Jeong, Seok
AU  - Jeong S
FAU - Cha, Sang-Woo
AU  - Cha SW
FAU - Cho, Young Deok
AU  - Cho YD
FAU - Kim, Hong Ja
AU  - Kim HJ
FAU - Kim, Jong Hyeok
AU  - Kim JH
FAU - Moon, Jong Ho
AU  - Moon JH
FAU - Park, Sang-Heum
AU  - Park SH
FAU - Itoi, Takao
AU  - Itoi T
FAU - Isayama, Hiroyuki
AU  - Isayama H
FAU - Kogure, Hirofumi
AU  - Kogure H
FAU - Lee, Se Joon
AU  - Lee SJ
FAU - Jung, Kyo Tae
AU  - Jung KT
FAU - Lee, Hye Sun
AU  - Lee HS
FAU - Baron, Todd H
AU  - Baron TH
FAU - Lee, Dong Ki
AU  - Lee DK
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Multicenter Study
DEP - 20121208
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
SB  - IM
CIN - Dig Dis Sci. 2013 Apr;58(4):894-6. PMID: 23456501
CIN - Dig Dis Sci. 2013 May;58(5):1438. PMID: 23504351
CIN - Dig Dis Sci. 2013 Aug;58(8):2427-8. PMID: 23673727
CIN - Dig Dis Sci. 2013 Aug;58(8):2426-7. PMID: 23812860
CIN - Dig Dis Sci. 2013 May;58(5):1438-9. PMID: 23841148
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cholangiopancreatography, Endoscopic Retrograde/*adverse effects/mortality
MH  - Fatal Outcome
MH  - Female
MH  - Gallstones/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Republic of Korea/epidemiology
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2012/12/12 06:00
MHDA- 2013/05/29 06:00
CRDT- 2012/12/11 06:00
PHST- 2012/07/19 00:00 [received]
PHST- 2012/11/11 00:00 [accepted]
PHST- 2012/12/11 06:00 [entrez]
PHST- 2012/12/12 06:00 [pubmed]
PHST- 2013/05/29 06:00 [medline]
AID - 10.1007/s10620-012-2494-8 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2013 Apr;58(4):1100-9. doi: 10.1007/s10620-012-2494-8. Epub 2012 Dec 
      8.