scholarly journals Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry

Gut ◽  
1997 ◽  
Vol 41 (4) ◽  
pp. 541-544 ◽  
Author(s):  
H Sato ◽  
T Kodama ◽  
J Takaaki ◽  
Y Tatsumi ◽  
T Maeda ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Dilatation ◽  
Sphincter Of Oddi ◽  
Partial Recovery ◽  
Endoscopic Manometry ◽  
Basal Pressure ◽  
Cbd Stones ◽  
Significant Difference ◽  
Endoscopic Papillary Balloon Dilatation

Background—Endoscopic papillary balloon dilatation (EPBD) has been reported as a safe and effective alternative to endoscopic sphincterotomy in the management of common bile duct (CBD) stones; its effect on papillary function has yet to be elucidated.Aim—To investigate sphincter of Oddi (SO) motility before and after EPBD to determine its effect on SO function.Patients and methods—The papillary function of 10 patients with CBD stones was studied using endoscopic manometry before and one week after EPBD. The manometric studies were repeated one month after EPBD in seven patients.Results—One week after EPBD, CBD pressure, SO peak pressure, SO basal pressure, and SO frequency decreased significantly. One month after EPBD, however, all parameters increased although the increases in SO basal pressure and CBD pressure were not significant. There was no significant difference in values of any parameter before and one month after EPBD. No serious complications occurred.Conclusion—These data suggest at least partial recovery of papillary function one month after the procedure. EPBD seems to preserve papillary function in treatment of CBD stones; a longer term follow up study with SO manometry should be performed to clarify the effect of EPBD on SO function.

scholarly journals Manometric Measurement of the Sphincter of Oddi in Patients with Common Bile Duct Stones: A Consecutive Study of the Han Population of China

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Yadong Feng ◽  
Jie Zhang ◽  
Chunhua Jiao ◽  
Hong Zhu ◽  
Wenfang Cheng ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Motor Activity ◽  
Common Bile Duct Stones ◽  
Sphincter Of Oddi ◽  
Pressure Amplitude ◽  
Chinese Han ◽  
Han Population ◽  
Cbd Stones ◽  
Significant Difference

Objective. Role of dysfunction of the sphincter of Oddi (SO) in choledocholithiasis is controversial. This study was to evaluate SO motor activity in patients with common bile duct (CBD) stones in the Han population of China.Patients and Methods. In this study, 76 patients with CBD stones were enrolled in a single tertiary endoscopy center. Data of SO motor activities was prospectively evaluated by endoscopic manometry. Mean basal SO pressure, amplitude, and frequency were collected and analyzed.Results. The mean basal SO pressure, amplitude, and frequency were52.7±40.0(1.60–171.1) mmHg,39.9±19.7(14.9–115.5) mmHg, and5.7±3.2(1.3–13.8)/min, respectively. The basal SO pressure was higher in patients with CBD stones < 10 mm in diameter than that in those with CBD stones larger than 10 mm in diameter (60.7±41.0 mmHg versus36.8±29.4 mmHg,P=0.043). There was no significant difference in the basal SO pressure, amplitude, and frequency when compared with the CBD diameter, CBD stone number, prior cholecystectomy, periampullary diverticula, and symptoms. Levels of alanine aminotransferase, aspartate transaminase,γ-glutamyl transpeptidase, and alkaline phosphatase showed no significant difference in patients with normal or elevated basal SO pressure.Conclusion. These results identify that, in Chinese Han population, abnormalities of SO motor activity are associated with CBD stones.

scholarly journals Consequences of Stenting and Endoscopic Papillary Balloon Dilatation in Treatment of Large and Multiple Common Bile Duct Stones

2019 ◽  
Vol 11 (4) ◽  
pp. 205-210
Author(s):  
Ahmad Hormati ◽  
Mohammad Reza Ghadir ◽  
Ali Hasanpour Dehkordi ◽  
Farshad Yadollahi ◽  
Shahriar Salehitali ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Dilatation ◽  
Bile Ducts ◽  
Common Bile Duct Stones ◽  
Allocation Rule ◽  
Bile Duct Stones ◽  
Significant Difference ◽  
Endoscopic Papillary Balloon Dilatation ◽  
Duct Cleaning

BACKGROUND Although stenting for the treatment of large and multiple common bile duct stones has been acceptable to everyone, its efficacy and outcome have not been studied in comparison with other endoscopic procedures. The purpose of this study was to compare the consequences of stenting and endoscopic papilla balloon dilatation for the treatment of large and multiple common bile duct stones. METHODS In a double-blind clinical trial, of 431 patients with bile duct stones referred to the treatment center, 64 patients with multiple common bile duct stones ( ≥ 3) and more than 15 cm were selected for the study, then by random allocation rule the participants were allocated in two groups. They were entered into two different endoscopic papillary balloon dilatation (EPBD) and common bile ducts stenting treatments so that both procedures were performed by a person. Both groups were assessed from the point of views therapeutic outcomes such as duct cleaning, pancreatitis, isolated pain, and duct rupture. Data were collected by a self-made questionnaire that was used before and after the procedure to obtain the needed information. Then data were analyzed using SPSS software version 22 and descriptive and analytical tests were used as appropriated. RESULTS Although the duct cleaning and the complete removal of the stones in the stenting treatment procedure was 93.8%, and in EPBD was 78.3%, no significant difference was observed between the two groups (p = 0.14). Pancreatitis significantly increased after the first and second endoscopic retrograde cholangiopancreatography (ERCP) in the stent group compared with EPBD (p = 0.02). Also, the most frequent cases of isolated pain were in the endoscopic group EPBD (p = 0.0). However, the occurrence of perforation after first ERCP and EPBD was zero, but in the second stage of ERCP, 3.3% of the patients had perforations (p = 0.99). The results indicated that the shape of the stone (circular and angled) was not effective in the result of treatment in the two groups. CONCLUSION The results of this study indicated that in case of experience and skill in conducting the ERCP, common bile duct stenting is still the first line of treatment for large and multiple stones of the common bile ducts.

scholarly journals Surgical procedure for unexpected balloon burst complication during endoscopic balloon dilatation in a patient with common bile duct stones

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Koji Morishita ◽  
Hideaki Sasaki
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Dilatation ◽  
Rare Complication ◽  
Common Bile Duct Stones ◽  
Endoscopic Retrograde ◽  
Case Presentation ◽  
Endoscopic Balloon Dilatation ◽  
Cbd Stones ◽  
Endoscopic Balloon

Abstract Background Endoscopic balloon dilatation (EBD) is the established treatment for common bile duct (CBD) stones. Although pancreatitis and bleeding have been reported as major complications of EBD, balloon-related complications are rarely reported in EBD. Case presentation A 30-year-old woman with suspected CBD stones underwent endoscopic retrograde cholangiopancreatography (ERCP) and EBD. During EBD, the balloon of the EBD catheter suddenly burst at the biliary sphincter. We therefore performed surgical intervention: removal of the broken EBD catheter and T-tube drainage. Finally, the patient was discharged without any complications. Conclusions We present a case involving a burst balloon of an EBD catheter as a rare complication during EBD, as well as the surgical technique that was used to treat this complication.

Comparison between endoscopic papillary balloon dilatation and endoscopic sphincterotomy for the treatment of common bile duct stones

2007 ◽  
Vol 42 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Hidetaka Watanabe ◽  
Masashi Yoneda ◽  
Keiichi Tominaga ◽  
Tsuneo Monma ◽  
Kazunari Kanke ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Sphincterotomy ◽  
Balloon Dilatation ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Endoscopic Papillary Balloon Dilatation

scholarly journals Recurrent common bile duct stones after endoscopic papillary balloon dilatation with or without precut sphincterotomy

2001 ◽  
Vol 58 (2) ◽  
pp. 44-48
Author(s):  
Hidejiro Urakami ◽  
Kouichi Aiura ◽  
Yoshio Matsui ◽  
Yasushi Iwasaki ◽  
Kouichiro Kumai ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Dilatation ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Precut Sphincterotomy ◽  
Endoscopic Papillary Balloon Dilatation

scholarly journals P.14.10 ENDOSCOPIC PAPILLARY BALLOON DILATATION FOR LARGE COMMON BILE DUCT STONES

2013 ◽  
Vol 45 ◽  
pp. S191
Author(s):  
M. Zippi ◽  
C. Cassieri ◽  
I. De Felici ◽  
R. Pica ◽  
G. Traversa ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Dilatation ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Endoscopic Papillary Balloon Dilatation

Sequential Endoscopic Papillary Balloon Dilatation Following Limited Sphincterotomy for Common Bile Duct Stones

2008 ◽  
Vol 54 (7) ◽  
pp. 1578-1581 ◽  
Author(s):  
Rakesh Kochhar ◽  
Usha Dutta ◽  
Rajat Shukla ◽  
Birinder Nagi ◽  
Kartar Singh ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Dilatation ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Endoscopic Papillary Balloon Dilatation

scholarly journals Increased Prevalence of Subclinical Hypothyroidism in Common Bile Duct Stone Patients

2007 ◽  
Vol 92 (11) ◽  
pp. 4260-4264 ◽  
Author(s):  
Johanna Laukkarinen ◽  
Gediminas Kiudelis ◽  
Marko Lempinen ◽  
Sari Räty ◽  
Hanna Pelli ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Subclinical Hypothyroidism ◽  
Sphincter Of Oddi ◽  
Liver Function Tests ◽  
Control Group ◽  
Cbd Stones ◽  
History Of ◽  
Cbd Stone ◽  
Previous Medical History

Abstract Context: Earlier, we have shown an increased prevalence of previously diagnosed hypothyroidism in common bile duct (CBD) stone patients and a delayed emptying of the biliary tract in hypothyroidism, explained partly by the missing prorelaxing effect of T4 on the sphincter of Oddi contractility. Objective: In this study, the prevalence of previously undiagnosed subclinical hypothyroidism in CBD stone patients was compared with nongallstone controls. Patients: All patients were clinically euthyreotic and without a history of thyroid function abnormalities. CBD stones were diagnosed at endoscopic retrograde cholangiopancreatography (group 1; n = 303) or ruled out by previous medical history, liver function tests, and ultrasonography (control group II; n = 142). Main Outcome Measures: Serum free FT4 and TSH (S-TSH) were analyzed; S-TSH above the normal range (&gt;6.0 mU/liter) was considered as subclinical and S-TSH 5.0–6.0 mU/liter as borderline-subclinical hypothyroidism. Results: A total of 5.3 and 5.0% (total 10.2%; 31 of 303) of the CBD stone patients were diagnosed to have subclinical and borderline-subclinical hypothyroidism, compared with 1.4% (P = 0.05) and 1.4% (total 2.8%, four of 142; P = 0.026) in the control group, respectively. In women older than 60 yr, the prevalence of subclinical hypothyroidism was 11.4% in CBD stone and 1.8% in control patients (P = 0.032) and subclinical plus borderline-subclinical hypothyroidism 23.8% in CBD stone and 1.8% in control patients (P = 0.012). Conclusion: Subclinical hypothyroidism is more common in the CBD stone patients, compared with nongallstone controls, supporting our hypothesis that hypothyroidism might play a role in the forming of CBD stones. At minimum, women older than 60 yr with CBD stones should be screened for borderline or overt subclinical hypothyroidism.

scholarly journals Detection of Common Bile Duct Stones in Mild Acute Biliary Pancreatitis Using Magnetic Resonance Cholangiopancreatography

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
David Aranovich ◽  
Veacheslav Zilbermints ◽  
Natalia Goldberg ◽  
Oleg Kaminsky
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Cbd Stones ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background. All patients with mild acute biliary pancreatitis should undergo early cholecystectomy. Whether routine common bile duct (CBD) imaging should be employed before the surgical procedure in these patients is a matter of current controversy. The aim of this study was to investigate the rate of detection of CBD stones using magnetic resonance cholangiopancreatography (MRCP) at different time intervals from admission. Methods. From January 1, 2011, through December 31, 2016, 72 patients with acute biliary pancreatitis underwent MRCP. Fifty-six (n=56) of them with mild biliary pancreatitis met the study criteria. The patients were divided into two groups. Group A did not have stones in the CBD (n=45), and Group B had stones in the CBD (n=11). The time from admission to MRCP was divided into several periods (day 1 through day 180), and the presence of the CBD stones on MRCP was weighted against remoteness from admission. Liver chemistry profiles were compared between the groups on admission and before the MRCP. Results. The cumulative rate of choledocholithiasis was 19.7% (Group B, n=11). Forty-five patients (Group A, n=45, 80.3%) did not have gallstones in the CBD. Eight patients with choledocholithiasis (8/56, 14.2%) were detected during the first 10 days from admission out of 27 patients. In patients who underwent MRCP between days 11 and 20, choledocholithiasis was found in two patients (2/56, 3.5%) and in one patient between days 21 and 30 (1/56, 1.8%). No stones were found in patients who underwent MRCP beyond 30 days from admission. Liver chemistry profiles did not show a significant difference in both groups. CBD dilatation was observed at presentation in 11 patients (n=11/56), 6 in Group A (6/45, 13.3%) and 5 in Group B (5/11, 45.5%) (p=0.016). Conclusions. Routine CBD evaluation should be encouraged after mild acute biliary pancreatitis. Early performance of MRCP gives high yield in selecting the patients for endoscopic retrograde cholangiopancreatography (ERCP) before cholecystectomy. A liver chemistry profile either on admission or before MRCP cannot predict the presence of CBD stones.

scholarly journals Endoscopic papillary balloon dilatation in comparison with endoscopic sphincterotomy for the treatment of large common bile duct stone

2013 ◽  
Vol 2 (1) ◽  
pp. 46 ◽  
Author(s):  
Ahmad Shavakhi ◽  
Neda Alijanian ◽  
Mehri Hajalikhani ◽  
Alireza Jafari ◽  
Mahammad Minakari ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Endoscopic Sphincterotomy ◽  
Balloon Dilatation ◽  
Bile Duct Stone ◽  
Endoscopic Papillary Balloon Dilatation
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