Clinical Effects of Endoscopic Papillary Balloon Dilation with Different Size Balloons on Sphincter of Oddi Function for Removing Common Bile Duct Stones

Sheng-Chen, Qing-Hua Wu, Qian-Yi Li, Yang-Qi, Wei-Yao, Lei-Kong, Rui-Yun Xu and Neng-Ping Li*

Department of General Surgery, Shanghai Jiaotong University School of Medicine, Affiliated Ruijin Hospital, China

^*Correspondance to: Neng-Ping Li 

 PDF  Full Text DOI: 10.25107/2474-1647.3459

Abstract

Aim: To evaluate the clinical effects of Endoscopic Papillary Balloon Dilation (EPBD) with differentsized balloons on the function of the Sphincter of Oddi (SO) for removing Common Bile Duct (CBD) stones. Methods: Consecutive patients with CBD stones treated successfully with EPBD from May 2010 to January 2019 were enrolled. The study patients underwent Limited Endoscopic Sphincterotomy (LEST) or EPBD with 8 mm, 10 mm, 12 mm, or 14 mm balloons for bile duct clearance. Watersoluble contrast gastrointestinal cholangiography was performed 12 months after EPBD to assess the Duodenobiliary Reflux (DBR) of the contrast agent. Abdominal imaging was performed to assess pneumobilia. Results: A total of 1139 patients were included. The incidence of DBR was 0%, 1.5%, and 7.4% in the LEST, 8 mm to 10 mm small-balloon EPBD, and 12 mm to 14 mm large-balloon EPBD groups, respectively (P<0.05). The incidence of pneumobilia in each group was highest at 1 month after the procedure. The incidence of pneumobilia increased proportionately with the diameter of the balloon (57.9% in the 14 mm group and 5.6% in the 8 mm group). The incidence of pneumobilia gradually decreased with time; however, the differences among the groups were statistically significant at 1, 6, and 12 months after EPBD (P<0.001). The incidence of recurrent CBD stones, acute cholangitis, and acute cholecystitis among the groups was similar. No patient developed hepatic abscess or bile duct cancer during the follow-up period. Conclusion: EPBD with a large balloon may cause greater damage to SO function than with a small balloon, leading to a higher incidence of DBR and pneumobilia. However, no obvious significant clinical effects were observed.

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Cite the article

Sheng-Chen, Wu Q-H, Li Q-Y, Yang- Qi, Wei-Yao, Lei-Kong, et al. Clinical Effects of Endoscopic Papillary Balloon Dilation with Different Size Balloons on Sphincter of Oddi Function for Removing Common Bile Duct Stones. Clin Surg. 2022; 7: 3459..