Endoscopic papillary balloon dilatation is a possible alternative to endoscopic sphincterotomy for the treatment of bile duct stones.
However, the effectiveness and safety of endoscopic papillary balloon dilatation is not clear.
|There were no severe complications and no mortality in either group.|
In this study, researchers from Japan assessed 272 patients with bile duct stones.
Patients were enrolled and randomized to either an endoscopic sphincterotomy or endoscopic papillary balloon dilatation group.
The team then prospectively evaluated the success rate for duct clearance, as well as the frequency and type of any complications.
Endoscopic sphincterotomy was performed in a standard manner. Endoscopic papillary balloon dilatation was carried out with gradual inflation of a 4-, 6-, or 8-mm diameter balloon.
The researchers found that complete duct clearance was achieved in 100% of the endoscopic sphincterotomy group, and 99% of the endoscopic papillary balloon dilatation group.
In addition, complications occurred in 12% of patients in the endoscopic sphincterotomy group and 15% of those in the endoscopic papillary balloon dilatation group.
In both groups there were no severe complications and no mortality.
However, the frequency of acute pancreatitis was higher in the endoscopic papillary balloon dilatation group (11%), than the endoscopic sphincterotomy group (3%).
In contrast, hemorrhage occurred only in the endoscopic sphincterotomy group.
Dr Naotaka Fujita's team concluded, "Endoscopic sphincterotomy and endoscopic papillary balloon dilatation were approximately equal in terms of successful clearance of bile duct stones".
"They were also similar with respect to overall complications."
"Endoscopic papillary balloon dilatation is an alternative to endoscopic sphincterotomy as a treatment of bile duct stones."