摘要
Background Endoscopic papillary balloon dilation reduces sphincter function at least transiently or partially, which may allow pancreatobiliary and duodenobil iary reflux to occur. This study prospectively evaluated pancreatobiliary and du odenobiliary reflux after endoscopic papillary balloon dilation. Methods In 12 p atients with choledocholithiasis, ductal bile was sampled for amylase concentrat ion and bacterial culture during ERCP,before and at 7 days to 5 years after endo scopic papillary balloon dilation. To provide comparative and control data, duct al bile was sampled in 12 patients with gallbladder cholesterol polyps and 6 wit h anomalous pancreaticobiliary junction who did not undergo endoscopic papillary balloon dilation. Results Amylase concentrations in ductal bile from patients w ith choledocholithiasis before endoscopic papillary balloon dilation were margin ally significantly higher (before Bonferroni correction) compared with concentra tions in bile from patients with gallbladder polyps. The concentration of amylas e in bile was significantly increased at 7 days after endoscopic papillary ballo on dilation compared with that before endoscopic papillary balloon dilation; the level was comparable with that of patients with an anomalous pancreaticobiliary junction. Subsequently,the amylase concentration gradually decreased and was ap proximately equal to the pre-endoscopic papillary balloon dilation level at 1 y ear. Bacteriocholia was frequent (67%-92%) for up to 3 months after endoscopi c papillary balloon dilation but was rare thereafter. Conclusions Endoscopic pap illary balloon dilation causes transient pancreatobiliary and duodenobili-ary r eflux. However, reflux is no longer present at 1 year after endoscopic papillary balloon dilation.
Background Endoscopic papillary balloon dilation reduces sphincter function at least transiently or partially, which may allow pancreatobiliary and duodenobil iary reflux to occur. This study prospectively evaluated pancreatobiliary and du odenobiliary reflux after endoscopic papillary balloon dilation. Methods In 12 p atients with choledocholithiasis, ductal bile was sampled for amylase concentrat ion and bacterial culture during ERCP,before and at 7 days to 5 years after endo scopic papillary balloon dilation. To provide comparative and control data, duct al bile was sampled in 12 patients with gallbladder cholesterol polyps and 6 wit h anomalous pancreaticobiliary junction who did not undergo endoscopic papillary balloon dilation. Results Amylase concentrations in ductal bile from patients w ith choledocholithiasis before endoscopic papillary balloon dilation were margin ally significantly higher (before Bonferroni correction) compared with concentra tions in bile from patients with gallbladder polyps. The concentration of amylas e in bile was significantly increased at 7 days after endoscopic papillary ballo on dilation compared with that before endoscopic papillary balloon dilation; the level was comparable with that of patients with an anomalous pancreaticobiliary junction. Subsequently,the amylase concentration gradually decreased and was ap proximately equal to the pre-endoscopic papillary balloon dilation level at 1 y ear. Bacteriocholia was frequent (67%-92%) for up to 3 months after endoscopi c papillary balloon dilation but was rare thereafter. Conclusions Endoscopic pap illary balloon dilation causes transient pancreatobiliary and duodenobili-ary r eflux. However, reflux is no longer present at 1 year after endoscopic papillary balloon dilation.
