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Endoscopic treatment of extreme esophageal stenosis complicated with esophagotracheal fistula: A case report
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作者 Jia-Heng Fang Wei-Min Li +4 位作者 Cheng-Hai He Jian-Liang Wu Yun Guo Zhi-Chao Lai Guo-Dong Li 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第1期239-247,共9页
BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ... BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD. 展开更多
关键词 Extreme corrosive esophageal stenosis Esophagotracheal fistula endoscopic incision method Esophageal stent placement endoscopic balloon dilation Case report
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Effect of endoscopic sphincterotomy and endoscopic papillary balloon dilation endoscopic retrograde cholangiopancreatographies on the sphincter of Oddi
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作者 Kai Fu Ying-Ying Yang +3 位作者 Hui Chen Guang-Xin Zhang Yan Wang Zhi Yin 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第6期1726-1733,共8页
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP),with its clinical ad-vantages of less trauma and faster recovery,has become the primary treatment for choledocholithiasis.AIM To investigate the effects ... BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP),with its clinical ad-vantages of less trauma and faster recovery,has become the primary treatment for choledocholithiasis.AIM To investigate the effects of different ERCP procedures on the sphincter of Oddi.METHODS The clinical data of 91 patients who underwent ERCP at Yixing Hospital of Traditional Chinese Medicine between February 2018 and February 2021 were analyzed retrospectively.The patients were divided into endoscopic sphinc-terotomy(EST,n=24)and endoscopic papillary balloon dilation(EPBD,n=67)groups.The duration of operation,pancreatic development,pancreatic sphinc-terotomy,intubation difficulties,stone recurrence,and incidence of reflux cho-langitis and cholecystitis were statistically analyzed in patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction in the EST and EPBD groups.RESULTS Differences in hypertension,diabetes,increased bilirubin,small diameter of the common bile duct,or ampullary diverticulum between the two groups were not significant.Statistically significant differences were observed between the two groups concerning sex and age(<60 years).Patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction were higher in the EST group than in the EPBD group.The number of cases of pancreatic development,pancreatic duct sphincterotomy,and difficult intubation were higher in the EST group than in the EPBD group.The number of Oddi’s sphincter manometries,ERCP surgical outcomes,and guidewires entering the pancreatic duct several times in EST group were lower than those in the EPBD group.The numbers of stone recurrences,reflux cholangitis,and cholecystitis were higher in the EST group than in the EPBD group.CONCLUSION In summary,common bile duct stones,pancreatitis history,and multiple guided wire introductions into the pancreatic duct are independent risk factors for EST and EPBD.Based on this evidence,this study can provide actionable insights for clinicians and researchers. 展开更多
关键词 ODDI CHOLANGIOPANCREATOGRAPHY endoscopic retrograde Risk factors endoscopic sphincterotomy endoscopic papillary balloon dilation
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Clinical efficacy of laparoscopic cholecystectomy combined with endoscopic papillary balloon dilation in treatment of gallbladder stones with common bile duct stones: A retrospective study
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作者 Hong-Dan Liu Qi Zhang +1 位作者 Wen-Si Xu Shuang Jin 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第6期1700-1708,共9页
BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic ... BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic papillary balloon dilation(EPBD)in patients with gallbladder stones(GS)with common bile duct stones(CBDS).METHODS The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC+EPBD group(n=50)or an LC+endoscopic sphincterotomy(EST)group(n=52)according to surgical methods.Surgery-related indexes,postoperative recovery,postoperative complications,and expression levels of inflammatory response indexes were compared between the two groups.RESULTS Total surgical time,stone free rate,rate of conversion to laparotomy,and successful stone extraction rate did not differ significantly between the LC+EPBD group and LC+EST group.Intraoperative hemorrhage,time to ambulation,and length of hospitalization in the LC+EPBD group were lower than those of the LC+EST group(P<0.05).The rate of total complications of the two groups was 9.80%and 17.65%,respectively,and the difference was not statistically significant.No serious complications occurred in either group.At 48 h postoperatively,the expression levels of interleukin-6,tumor necrosis factor-α,high-sensitivity Creactive protein,and procalcitonin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).At 3 d postoperatively,the expression levels of aspartate transaminase,alanine transaminase,and total bilirubin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).CONCLUSION LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS,in which LC combined with EPBD is beneficial to shorten the patient’s hospitalization time,reduce the magnitude of elevated inflammatory response indexes,and promote postoperative recovery. 展开更多
关键词 Gallbladder stone Common bile duct stone endoscopic papillary balloon dilation Laparoscopic cholecystectomy endoscopic sphincterotomy
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Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis? 被引量:24
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作者 Toshio Fujisawa Koichi Kagawa +3 位作者 Kantaro Hisatomi Kensuke Kubota Atsushi Nakajima Nobuyuki Matsuhashi 《World Journal of Gastroenterology》 SCIE CAS 2016年第26期5909-5916,共8页
Endoscopic papillary balloon dilatation(EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography(ERCP), including bleeding, biliary infection, and perforation, but it is ge... Endoscopic papillary balloon dilatation(EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography(ERCP), including bleeding, biliary infection, and perforation, but it is generally avoided in Western countries because of a relatively high reported incidence of post-ERCP pancreatitis(PEP). However, as the efficacy of endoscopic papillary largeballoon dilatation(EPLBD) becomes widely recognized, EPBD is attracting attention. Here we investigate whether EPBD is truly a risk factor for PEP, and seek safer and more effective EPBD procedures by reviewing past studies. We reviewed thirteen randomised control trials comparing EPBD and endoscopic sphincterotomy(EST) and ten studies comparing direct EPLBD and EST. Three randomized controlled trials of EPBD showed significantly higher incidence of PEP than EST, but no study of EPLBD did. Careful analysis of these studies suggested that longer and higher-pressure inflation of balloons might decrease PEP incidence. The paradoxical result that EPBD with small-calibre balloons increases PEP incidence while EPLBD does not may be due to insufficient papillary dilatation in the former. Insufficient dilatation could cause the high incidence of PEP through the use of mechanical lithotripsy and stress on the papilla at the time of stone removal. Sufficient dilation of the papilla may be useful in preventing PEP. 展开更多
关键词 endoscopic papillary balloon dilatation Post-endoscopic retrograde cholangio-pancreatography pancreatitis endoscopic papillary large-balloon dilatation endoscopic sphincterotomy Randomized controlled trial
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Endoscopic balloon catheter dilatation via retrograde or static technique is safe and effective for cricopharyngeal dysfunction 被引量:6
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作者 Vinay Chandrasekhara Joyce Koh +3 位作者 Lakshmi Lattimer Kerry B Dunbar William J Ravich John O Clarke 《World Journal of Gastrointestinal Endoscopy》 CAS 2017年第4期183-188,共6页
To evaluate the safety and efficacy of upper esophageal sphincter (UES) dilatation for cricopharyngeal (CP) dysfunction. To determine if: (1) indication for dilatation; or (2) technique of dilatation correlated with s... To evaluate the safety and efficacy of upper esophageal sphincter (UES) dilatation for cricopharyngeal (CP) dysfunction. To determine if: (1) indication for dilatation; or (2) technique of dilatation correlated with symptom improvement. METHODSAll balloon dilatations performed at our institution from over a 3-year period were retrospectively analyzed for demographics, indication and dilatation site. All dilatations involving the UES underwent further review to determine efficacy, complications, and factors that predict success. Dilatation technique was separated into static (stationary balloon distention) and retrograde (brusque pull-back of a fully distended balloon across the UES). RESULTSFour hundred and eighty-eight dilatations were reviewed. Thirty-one patients were identified who underwent UES dilatation. Median age was 63 years (range 27-81) and 55% of patients were male. Indications included dysphagia (28 patients), globus sensation with evidence of UES dysfunction (2 patients) and obstruction to echocardiography probe with cricopharyngeal (CP) bar (1 patient). There was evidence of concurrent oropharyngeal dysfunction in 16 patients (52%) and a small Zenker’s diverticula (≤ 2 cm) in 7 patients (23%). Dilator size ranged from 15 mm to 20 mm. Of the 31 patients, 11 had dilatation of other esophageal segments concurrently with UES dilatation and 20 had UES dilatation alone. Follow-up was available for 24 patients for a median of 2.5 mo (interquartile range 1-10 mo), of whom 19 reported symptomatic improvement (79%). For patients undergoing UES dilatation alone, follow-up was available for 15 patients, 12 of whom reported improvement (80%). Nineteen patients underwent retrograde dilatation (84% response) while 5 patients had static dilatation (60% response); however, there was no significant difference in symptom improvement between the techniques (P = 0.5). Successful symptom resolution was also not significantly affected by dilator size, oropharyngeal dysfunction, Zenker’s diverticulum, age or gender (P > 0.05). The only complication noted was uvular edema and a shallow ulcer after static dilatation in one patient, which resolved spontaneously and did not require hospital admission. CONCLUSIONUES dilatation with a through-the-scope balloon by either static or retrograde technique is safe and effective for the treatment of dysphagia due to CP dysfunction. To our knowledge, this is the first study evaluating retrograde balloon dilatation of the UES. 展开更多
关键词 Cricopharygeal dysfunction Cricopharyngeal bar DYSPHAGIA Esophageal dilatation endoscopic balloon dilation
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Predictors of outcomes of endoscopic balloon dilatation in strictures after esophageal atresia repair: A retrospective study 被引量:5
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作者 Dong-Ling Dai Chen-Xi Zhang +3 位作者 Yi-Gui Zou Qing-Hua Yang Yu Zou Fei-Qiu Wen 《World Journal of Gastroenterology》 SCIE CAS 2020年第10期1080-1087,共8页
BACKGROUND Endoscopic balloon dilatation (EBD) has become the first line of therapy for benign esophageal strictures (ESs);however,there are few publications about the predictive factors for the outcomes of this treat... BACKGROUND Endoscopic balloon dilatation (EBD) has become the first line of therapy for benign esophageal strictures (ESs);however,there are few publications about the predictive factors for the outcomes of this treatment.AIM To assess the predictive factors for the outcomes of EBD treatment for strictures after esophageal atresia (EA) repair.METHODS Children with anastomotic ES after thoracoscopic esophageal atresia repair treated by EBD from January 2012 to December 2016 were included.All procedures were performed under tracheal intubation and intravenous anesthesia using a three-grade controlled radial expansion balloon with gastroscopy.Outcomes were recorded and predictors of the outcomes were analyzed.RESULTS A total of 64 patients were included in this analysis.The rates of response,complications,and recurrence were 96.77%,8.06%,and 2.33%,respectively.The number of dilatation sessions and complications were significantly higher in patients with a smaller stricture diameter (P=0.013 and 0.023,respectively) and with more than one stricture (P=0.014 and 0.004,respectively).The length of the stricture was significantly associated with complications of EBD (P=0.001).A longer interval between surgery and the first dilatation was related to more sessions and a poorer response (P=0.017 and 0.024,respectively).CONCLUSION The diameter,length,and number of strictures are the most important predictive factors for the clinical outcomes of endoscopic balloon dilatation in pediatric ES.The interval between surgery and the first EBD is another factor affectingresponse and the number of sessions of dilatation. 展开更多
关键词 CHILDREN endoscopic balloon dilatation Esophageal stricture OUTCOME PREDICTOR
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Long-term outcomes of endoscopic papillary large-balloon dilation(12-15 mm)with or without limited sphincterotomy for removal of bile duct stones 被引量:1
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作者 Tao Li Li-Xiao Hao +6 位作者 Chan Lv Xing-Jia Li Xiao-Dan Ji Meng Chen Chang Liu Li-Ke Bie Biao Gong 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2023年第4期392-398,共7页
Background:Limited endoscopic sphincterotomy with large balloon dilation(ES-LBD)and endoscopic papillary large-balloon dilation(EPLBD)have been proven safe and effective for removal of bile duct stones.However,the lon... Background:Limited endoscopic sphincterotomy with large balloon dilation(ES-LBD)and endoscopic papillary large-balloon dilation(EPLBD)have been proven safe and effective for removal of bile duct stones.However,the long-term outcomes are not clear.The aim of this study was to assess the long-term outcomes of EPLBD(12-15 mm)with or without limited sphincterotomy for removal of common bile duct(CBD)stones.Methods:Patients with EPLBD or ES-LBD referred for the removal of bile-duct stones between June 2008 and August 2020 were retrospectively reviewed.Complete stone clearance,endoscopic retrograde cholangiopancreatography(ERCP)-related adverse events,and late biliary complications during long-term follow-up were analyzed.Results:Basic patient characteristics were not significantly different between the groups that underwent EPLBD(n=168)and ES-LBD(n=57).EPLBD compared with ES-LBD resulted in similar outcomes in terms of overall successful stone removal(99.4%vs.100%,P=1.00)and ERCP-related adverse events(7.7%vs.5.3%,P=0.77).The mean duration of the follow-up were 113.6 months and 106.7 months for patients with EPLBD and ES-LBD,respectively(P=0.13).There was no significant difference between EPLBD and ES-LBD in the incidence of stone recurrence[20(11.9%)vs.9(15.8%);P=0.49].Multivariate analysis showed that a diameter of CBD≥15 mm(OR=3.001;95%CI:1.357-6.640;P=0.007)was an independent risk factor for stone recurrence.Conclusions:The application of a large balloon(12-15 mm)via EPLBD is an effective and safe alternative to ES-LBD for extraction of large CBD stones.Endoscopic sphincterotomy prior to EPLBD may be unnec-essary.A diameter of CBD≥15 mm is a risk factor of stone recurrence. 展开更多
关键词 endoscopic papillary large-balloon dilation endoscopic sphincterotomy Bile duct stone
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Caustic Esophageal Stenosis: Epidemiological, Clinical, Endoscopic and Therapeutic Aspects at the Gabriel TouréUniversity Hospital in Bamako
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作者 Sow Hourouma wife Coulibaly Doumbia Kadiatou wife Samaké +5 位作者 Dicko Moussa Younoussa Tounkara Makan Siré Sanaogo Déborah wife Sidibé Anselme Konaté Moussa Tiemoko Diarra Moussa Youssoufa Maiga 《Open Journal of Gastroenterology》 2021年第10期203-209,共7页
Voluntary or accidental ingestion of a caustic product is increasingly en<span><span><span style="font-family:;" "="">countered in our count</span></span></spa... Voluntary or accidental ingestion of a caustic product is increasingly en<span><span><span style="font-family:;" "="">countered in our count</span></span></span><span><span><span style="font-family:;" "="">ry</span></span></span><span><span><span style="font-family:;" "="">. Caustic esophageal stenosis is the most common sequel. Its treatment involves instrumental dilation and/or surgery which is particularly heavy.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">The aim of this study was to study the epidemiological, clinical and therapeutic aspects of caustic esophageal strictures in our context. The retrospective study took place from December 2013 to December 2017 in the Hepato-Gastroenterology department of the Gabriel Touré</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">university hospital in Bamako. We included patients with caustic esophageal stenosis referred to the gastrointestinal endoscopy unit for dilation. 67 patients admitted for caustic stenosis were included. The mean age of our patients was 20.76 ± 19.9 years with extremes of 1 and 70 years and a sex ratio of 1.9. In 50.7% of cases, the product ingested was basic in nature. The clinical symptomatology was dominated by dysphagia (100%), vomiting (100%), the emaciated (60%) and cough (40%). In 59 (88%) patients</span></span></span><span><span><span style="font-family:;" "="">,</span></span></span><span><span><span style="font-family:;" "=""> the stenosis was unique and multiple in 8 <span>(12%). The KILLIAN mouth as the sole site of the stenosis was found in</span> 40.3% of patients. The number of sessions was ≤ 3 in 16.4% and </span></span></span><span><span><span style="font-family:;" "="">></span></span></span><span><span><span style="font-family:;" "="">3 in 83.6% with a mean of 4.59 ± 1.57 sessions. The evolution was favorable </span></span></span><span><span><span style="font-family:;" "="">in 95.5% of our patients. However</span></span></span><span><span><span style="font-family:;" "="">,</span></span></span><span><span><span style="font-family:;" "=""> we recorded three </span></span></span><span><span><span style="font-family:;" "="">(</span></span></span><span><span><span style="font-family:;" "="">3</span></span></span><span><span><span style="font-family:;" "="">)</span></span></span><span><span><span style="font-family:;" "=""> cases of death all following a perforation.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><b><span style="font-family:;" "="">Conclusion:</span></b></span></span><span><span><b><span style="font-family:;" "=""> </span></b></span></span><span><span><span style="font-family:;" "="">Caustic esophageal stenosis, a consequence of ingestion of caustics, is increasingly observed in our context. Endoscopic dilation occupies an important place in its management.</span></span></span> 展开更多
关键词 Causticstenosis ESOPHAGUS endoscopic dilatation
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Small sphincterotomy combined with endoscopic papillary large balloon dilation vs sphincterotomy alone for removal of common bile duct stones 被引量:43
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作者 Shi-Bin Guo Hua Meng +1 位作者 Zhi-Jun Duan Chun-Yan Li 《World Journal of Gastroenterology》 SCIE CAS 2014年第47期17962-17969,共8页
AIM: To evaluate the efficacy and safety of endoscopic papillary large diameter balloon dilation (EPLBD) following limited endoscopic sphincterotomy (EST) and EST alone for removal of large common bile duct (CBD) stones.
关键词 CHOLEDOCHOLITHIASIS endoscopic retrograde cholangiopancreatography endoscopic papillary balloon dilation endoscopic sphincterotomy
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Minor endoscopic sphincterotomy followed by large balloon dilation for large choledocholith treatment 被引量:17
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作者 Xiao-Dan Xu Bo Chen +2 位作者 Jian-Jun Dai Jian-Qing Qian Chun-Fang Xu 《World Journal of Gastroenterology》 SCIE CAS 2017年第31期5739-5745,共7页
AIM To evaluate early and late outcomes of endoscopic papillary large balloon dilation(EPLBD) with minor endoscopic sphincterotomy(m EST) for stone removal.METHODS A total of 149 consecutive patients with difficult co... AIM To evaluate early and late outcomes of endoscopic papillary large balloon dilation(EPLBD) with minor endoscopic sphincterotomy(m EST) for stone removal.METHODS A total of 149 consecutive patients with difficult common bile duct(CBD) stones(diameter ≥ 10 mm or ≥ 3 stones) underwent conventional endoscopic sphincterotomy(EST) or m EST plus EPLBD from May 2012 to April 2016. Their demographic, laboratory and procedural data were collected, and pancreaticobiliary complications were recorded.RESULTS Sixty-nine(94.5%) of the patients in the EPLBD + m EST group and 64(84.2%) in the conventional EST group achieved stone clearance following the first session(P = 0.0421). The procedure time for EPLBD + m EST was shorter than for EST alone(42.1 ± 13.6 min vs 47.3 ± 11.8 min, P = 0.0128). The overall rate of early complications in the EPLBD + m EST group(11%) was lower than in the EST group(21.1%); however, the difference was not significant(P = 0.0938). The cumulative recurrence rate of cholangitis and CBD stones between the two groups was also similar. The procedure time was independently associated with post-endoscopic retrograde cholangiopancreatography pancreatitis(OR = 6.374, 95%CI: 1.193-22.624, P = 0.023), CBD stone diameter ≥ 16 mm(OR = 7.463, 95%CI: 2.705-21.246, P = 0.0452) and use of mechanical lithotripsy(OR = 9.913, 95%CI: 3.446-23.154, P = 0.0133) were independent risk factors for stone recurrence. CONCLUSION EPLBD with m EST is more effective than EST alone for difficult CBD stone removal, with shorter procedure time and fewer early complications. 展开更多
关键词 endoscopic papillary balloon dilation PANCREATITIS endoscopic sphincterotomy Common bile duct stones
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Endoscopic papillary large balloon dilation vs endoscopic sphincterotomy for retrieval of common bile duct stones:A meta-analysis 被引量:25
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作者 Piao-Piao Jin Jian-Feng Cheng +3 位作者 Dan Liu Mei Mei Zhao-Qi Xu Lei-Min Sun 《World Journal of Gastroenterology》 SCIE CAS 2014年第18期5548-5556,共9页
AIM: To compare the efficacy and safety of endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) in retrieval of common bile duct stones (&#x02265; 10 mm).
关键词 endoscopic papillary large balloon dilation endoscopic sphincterotomy Mechanical lithotripsy Common bile duct stones Meta analysis.
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Large balloon dilation post endoscopic sphincterotomy in removal of difficult common bile duct stones:A literature review 被引量:17
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作者 Olivier Rouquette Gilles Bommelaer +1 位作者 Armo Abergel Laurent Poincloux 《World Journal of Gastroenterology》 SCIE CAS 2014年第24期7760-7766,共7页
Endoscopic sphincterotomy (ES) is the standard therapy in common bile duct (CBD) stones extraction. Large stones (&#x02265; 12 mm) or multiple stones extraction may be challenging after ES alone. Endoscopic sphinc... Endoscopic sphincterotomy (ES) is the standard therapy in common bile duct (CBD) stones extraction. Large stones (&#x02265; 12 mm) or multiple stones extraction may be challenging after ES alone. Endoscopic sphincterotomy followed by large balloon dilation (ESLBD) has been described as an alternative to ES in these indications. Efficacy, safety, cost-effectiveness and technical aspects of the procedure have been here reviewed. PubMed and Google Scholar search resulted in forty-one articles dealing with CBD stone extraction with 12 mm or more dilation balloons after ES. ESLBD is at least as effective as ES, and reduces the need for additional mechanical lithotripsy. Adverse events rates are not statistically different after ESLBD compared to ES for pancreatitis, bleeding and perforation. However, particular attention should be paid in patients with CBD strictures, which is identified as a risk factor of perforation. ESLBD is slightly cost-effective compared to ES. A small sphincterotomy is usually performed, and may reduce bleeding rates compared to full sphincterotomy. Dilation is performed with 12-20 mm enteral balloons. Optimal inflation time is yet to be determined. The procedure can be performed safely even in patients with peri-ampullary diverticula and surgically altered anatomy. ESLBD is effective and safe in the removal of large CBD stones, however, small sphincterotomy might be preferred and CBD strictures should be considered as a relative contraindication. 展开更多
关键词 Bile duct stone endoscopic papillary large balloon dilation endoscopic sphincterotomy endoscopic retrograde cholangiopancreatography Mechanical lithotripsy
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Balloon dilation itself may not be a major determinant of post-endoscopic retrograde cholangiopancreatography pancreatitis 被引量:6
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作者 Sung Ill Jang Gak Won Yun Dong Ki Lee 《World Journal of Gastroenterology》 SCIE CAS 2014年第45期16913-16924,共12页
Endoscopic retrograde cholangiopancreatography (ERCP) is the essential first modality for common bile duct (CBD) stone therapy. The conventional endoscopic treatment for CBD stones is stone removal after endoscopic sp... Endoscopic retrograde cholangiopancreatography (ERCP) is the essential first modality for common bile duct (CBD) stone therapy. The conventional endoscopic treatment for CBD stones is stone removal after endoscopic sphincterotomy (EST). Stone removal after papillary stretching using balloon dilation instead of the conventional method has been widely adopted. There are many reports regarding endoscopic papillary balloon dilation (EPBD) utilizing a small balloon (&#x0003c; 10 mm) instead of EST for the removal of small CBD stones. In contrast, two cases of mortality due to post-ERCP pancreatitis (PEP) were reported after an EPBD clinical trial in the Western world, and the psychological barrier caused by these incidences hinders the use of this technique in Western countries. Endoscopic papillar large balloon dilation (EPLBD), which is used to treat large CBD stones, was not widely adopted when first introduced due to concerns about perforation and severe pancreatitis from the use of a large balloon (12-20 mm). However, as experience with this procedure accumulates, the occurrence of PEP with EPLBD is confirmed to be much lower than with EPBD. This report reviews whether EPBD and EPLBD, two procedures that use balloon dilation but differ in terms of indications and concept, contribute to the occurrence of PEP. 展开更多
关键词 Post-endoscopic retrograde cholangiopancreatography pancreatitis endoscopic papillary balloon dilation endoscopic papillary large balloon dilation Common bile duct stone
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Utility of endoscopic retrograde cholangiopancreatography on biliopancreatic diseases in patients with Billroth Ⅱ-reconstructed stomach 被引量:11
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作者 Yuji Sakai Toshio Tsuyuguchi +4 位作者 Rintaro Mikata Harutoshi Sugiyama Shin Yasui Masaru Miyazaki Osamu Yokosuka 《World Journal of Gastrointestinal Endoscopy》 CAS 2017年第3期127-132,共6页
AIM To examine the utility of endoscopic retrograde cholangiopancreatography(ERCP) on biliopancreatic diseases in the patients with Billroth II-reconstructed stomach.METHODS For 26 cases of biliopancreatic diseases in... AIM To examine the utility of endoscopic retrograde cholangiopancreatography(ERCP) on biliopancreatic diseases in the patients with Billroth II-reconstructed stomach.METHODS For 26 cases of biliopancreatic diseases in patients with Billroth Ⅱ-reconstructed stomach,ERCP was conducted using a straight-view scope or a retrograde obliqueviewing endoscope.All the cases were patients aiming at selective insertion into the bile duct.One patient aimed at diagnosis,and 25 patients aimed at treatment.The cases in which the endoscope reached the duodenal papilla and anastomosis,and insertion into the bile duct became possible,were considered successful.RESULTS The rate of reaching the duodenal papilla and anastomosis was 84.7%(22/26 patients).Among the cases without reaching the duodenal papilla and anastomosis,there were 2 in which the endoscope did not pass due to tumor-induced duodenal infiltration.In 1 case,the fiber did not reach the duodenal papilla due to long afferent loop.The success rate of insertion into the bile duct in patients in which the endoscope reached the duodenal papilla and anastomosis was 90.9%(20/22 patients),and the success rate of procedures including treatment was 86.3%(19/22 patients).After treatment,mild cholangitis was observed in 1 patient(4.5%,1/22 patients) but relieved conservatively.No other accidental symptom was observed.CONCLUSION It was considered that the ERCP for biliopancreatic diseases in patients with Billroth II-reconstructed stomach will become a less invasive,safe and useful examination and treatment approach. 展开更多
关键词 Billroth Ⅱ-reconstructed stomach endoscopic retrograde cholangiopancreatography endoscopic papillary balloon dilatation
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Long-term outcomes of endoscopic papillary balloon dilation for removal of bile duct stones in Billroth Ⅱ gastrectomy patients 被引量:6
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作者 Tao Li Jun Wen +2 位作者 Li-Ke Bie Yi Lu Biao Gong 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2018年第3期257-262,共6页
Background: Endoscopic papillary balloon dilation (EPBD) for common bile duct (CBD) stones removal in Billroth II gastrectomy patients is feasible. However, the long-term outcomes of this technique are notclear. ... Background: Endoscopic papillary balloon dilation (EPBD) for common bile duct (CBD) stones removal in Billroth II gastrectomy patients is feasible. However, the long-term outcomes of this technique are notclear. The aim of this study was to evaluate the procedural and long-term outcomes of EPBD for removal of CBD stones in Billroth II gastrectomy patients. 展开更多
关键词 endoscopic retrograde CHOLANGIOPANCREATOGRAPHY endoscopic papillary balloon dilation Common bile duct stonesBillroth II gastrectomy
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Endoscopic papillary large balloon dilation for removal of bile duct stones 被引量:6
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作者 Yuji Sakai Toshio Tsuyuguchi +17 位作者 Yoshiaki Kawaguchi Nobuto Hirata So Nakaji Katsuya Kitamura Shigeru Mikami Tatsuya Fujimoto Masashi Ijima Eishin Kurihara Shuhei Oana Takayoshi Nishino Ryo Tamura Dai Sakamoto Masato Nakamura Takao Nishikawa Harutoshi Sugiyama Hitoshi Yoshida Tetsuya Mine Osamu Yokosuka 《World Journal of Gastroenterology》 SCIE CAS 2014年第45期17148-17154,共7页
AIM: To investigate the efficacy and outcomes of endoscopic papillary large balloon dilation (EPLBD) for bile duct stones in a multicenter prospective study.
关键词 endoscopic retrograde cholangiopancreatography endoscopic sphincterotomy endoscopic papillary large balloon dilation Large bile duct stones Multiple bile duct stones
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Innovation of endoscopic management in difficult common bile duct stone in the era of laparoscopic surgery 被引量:10
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作者 Cosmas Rinaldi Adithya Lesmana Maria Satya Paramitha Laurentius Adrianto Lesmana 《World Journal of Gastrointestinal Endoscopy》 2021年第7期198-209,共12页
Common bile duct(CBD)stone is a common biliary problem,which often requires endoscopic approach as the initial treatment option.Roughly,7%-12%of the subjects who experience cholecystectomy were subsequently referred t... Common bile duct(CBD)stone is a common biliary problem,which often requires endoscopic approach as the initial treatment option.Roughly,7%-12%of the subjects who experience cholecystectomy were subsequently referred to biliary endoscopist for further management.In general,there are three classifications of difficult CBD stone,which are based on the characteristics of the stone(larger than 15 mm,barrel or square-shaped stones,and hard consistency),accessibility to papilla related to anatomical variations,and other clinical conditions or comorbidities of the patients.Currently,endoscopic papillary large balloon dilation(EPLBD)of a previous sphincterotomy and EPLBD combined with limited sphincterotomy performed on the same session is still recommended by the European Society of Gastrointestinal Endoscopy as the main approach in difficult CBD stones with history of failed sphincterotomy and balloon and/or basket attempts.If failed extraction is still encountered,mechanical lithotripsy or cholangioscopy-assisted lithotripsy or extracorporeal shockwave lithotripsy can be considered.Surgical approach can be considered when stone extraction is still failed or the facilities to perform lithotripsy are not available.To our knowledge,conflicting evidence are still found from previous studies related to the comparison between endoscopic and surgical approaches.The availability of experienced operator and resources needs to be considered in creating individualized treatment strategies for managing difficult biliary stones. 展开更多
关键词 Difficult common bile duct stones endoscopic sphincterotomy endoscopic papillary large balloon dilatation Mechanical lithotripsy CHOLANGIOSCOPY Laparoscopic surgery
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Cholecystectomy reduces subsequent cholangiocarcinoma risk in choledocholithiasis patients undergoing endoscopic intervention 被引量:2
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作者 Chi-Chih Wang Ming-Hseng Tseng +7 位作者 Sheng-Wen Wu Tzu-Wei Yang Hsuan-Yi Chen Wen-Wei Sung Chang-Cheng Su Yao-Tung Wang Chun-Che Lin Ming-Chang Tsai 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2020年第12期1381-1393,共13页
BACKGROUND Cholangiocarcinoma is a disease with a high mortality rate.Our previous study revealed that cholelithiasis patients who undergo endoscopic sphincterotomy(ES)/endoscopic papillary balloon dilatation are at a... BACKGROUND Cholangiocarcinoma is a disease with a high mortality rate.Our previous study revealed that cholelithiasis patients who undergo endoscopic sphincterotomy(ES)/endoscopic papillary balloon dilatation are at a higher risk for subsequent cholangiocarcinoma than cholelithiasis patients who undergo cholecystectomy.AIM To clarify the relationship between recurrent biliary events and subsequent cholangiocarcinoma risk in choledocholithiasis patients.METHODS From one million random cases in the Taiwan National Health Insurance Research Database 2004–2011,we selected symptomatic choledocholithiasis patients older than 18 years who were admitted from January 2005 to December 2009(study group).Cases for a control group were defined as individuals who had never been diagnosed with cholelithiasis,matched by sex and age in a 1:3 ratio.The study group was further divided into ES/endoscopic papillary balloon dilatation,both ES/endoscopic papillary balloon dilatation and cholecystectomy,and no intervention groups.RESULTS We included 2096 choledocholithiasis patients without previous intervention or cholangiocarcinoma.A total of 12(2.35%),11(0.74%),and 1(1.00%)subsequent cholangiocarcinoma cases were diagnosed among 511 ES/endoscopic papillary balloon dilatation patients,1485 patients with no intervention,and 100 ES/endoscopic papillary balloon dilatation and cholecystectomy patients,respectively.The incidence rates of recurrent biliary event were 527.79/1000 person-years and 286.69/1000 person-years in the subsequent cholangiocarcinoma and no cholangiocarcinoma group,showing a high correlation between subsequent cholangiocarcinoma risk and recurrent biliary events.CONCLUSION Choledocholithiasis patients who undergo further cholecystectomy after ES/endoscopic papillary balloon dilatation have decreased subsequent cholangiocarcinoma risk due to reduced recurrent biliary events. 展开更多
关键词 CHOLANGIOCARCINOMA endoscopic sphincterotomy endoscopic papillary balloon dilatation CHOLECYSTECTOMY Recurrent biliary events
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Biodegradable stent or balloon dilatation for benign oesophageal stricture: Pilot randomised controlled trial 被引量:1
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作者 Anjan Dhar Helen Close +6 位作者 Yirupaiahgari K Viswanath Colin J Rees Helen C Hancock A Deepak Dwarakanath Rebecca H Maier Douglas Wilson James M Mason 《World Journal of Gastroenterology》 SCIE CAS 2014年第48期18199-18206,共8页
AIM: To undertake a randomised pilot study comparing biodegradable stents and endoscopic dilatation in patients with strictures.
关键词 Benign oesophageal stricture Biodegradable stent endoscopic balloon dilatation Pilot study Randomised controlled trial DYSPHAGIA
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Fecal marker levels as predictors of need for endoscopic balloon dilation in Crohn's disease patients with anastomotic strictures 被引量:1
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作者 Susana Lopes Patrícia Andrade +3 位作者 Eduardo Rodrigues-Pinto Joana Afonso Guilherme Macedo Fernando Magro 《World Journal of Gastroenterology》 SCIE CAS 2017年第35期6482-6490,共9页
AIM To evaluate the accuracy and best cut-off value of fecal calprotectin(FC) and fecal lactoferrin(FL) to predict disease recurrence in asymptomatic patients presenting with anastomotic strictures. METHODS This was a... AIM To evaluate the accuracy and best cut-off value of fecal calprotectin(FC) and fecal lactoferrin(FL) to predict disease recurrence in asymptomatic patients presenting with anastomotic strictures. METHODS This was a longitudinal single tertiary center study based on prospectively collected data(recorded in a clinical database created for this purpose) performed between March 2010 and November 2014. Crohn's disease(CD) patients with anastomotic stricture who submitted to postoperative endoscopic evaluation were included. Stools were collected on the day before bowel cleaning for FC and FL. Endoscopic balloon dilation(EBD) was performed if the patient presented an anastomotic stricture not traversed by the colonoscope, regardless of patients' symptoms. Successful dilation was defined as passage of the colonoscope through the dilated stricture into the neotermimal ileum.Postoperative recurrence was defined as a modified Rutgeerts score of ≥ i2 b. RESULTS In a total of 178 patients who underwent colonoscopy, 58 presented an anastomotic stricture, 86% were asymptomatic, and 48(54% male; median age of 46.5 years) were successfully dilated. Immediate success rate was 92% and no complications were recorded. FC and FL levels correlated significantly with endoscopic recurrence(P < 0.001) with an optimal cut-off value of 90.85 μg/g(sensitivity of 95.5%, specificity of 69.2%, positive predictive value(PPV) of 72.4%, negative predictive value(NPV) of 94.7% and accuracy of 81%] for FC and of 5.6 μg/g(sensitivity of 77.3%, specificity of 69.2%, PPV of 68%, NPV of 78.4% and accuracy of 72.9%) for FL.CONCLUSION Fecal markers are good predictors of CD endoscopic recurrence in patients with asymptomatic anastomotic stricture. FC and FL may guide the need for EBD in this context. 展开更多
关键词 Crohn's disease Anastomotic strictures endoscopic balloon dilation Fecal markers Po stoperative recurrence
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