Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single‐centre experience
Background Balloon dilatation of the ampulla at endoscopic retrograde cholangiopancreatography (ERCP) is increasingly utilized in the management of large bile duct stones. The aim of this study was to review and compare the outcomes of using endoscopic sphincterotomy with endoscopic balloon dilatati...
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| Veröffentlicht in: | ANZ journal of surgery 2017-09, Vol.87 (9), p.695-699 |
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| container_title | ANZ journal of surgery |
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| creator | Ho, Simon Rayzan, Daniel Fox, Adrian Kalogeropoulos, George Mackay, Sean Hassen, Sayed Banting, Simon Cade, Richard |
| description | Background
Balloon dilatation of the ampulla at endoscopic retrograde cholangiopancreatography (ERCP) is increasingly utilized in the management of large bile duct stones. The aim of this study was to review and compare the outcomes of using endoscopic sphincterotomy with endoscopic balloon dilatation (sphincteroplasty) in a combined approach as a single‐stage (immediate) or a two‐stage procedure (delayed).
Methods
A retrospective review of medical records for all patients undergoing ERCP and balloon dilatation for choledocholithiasis between January 2010 and December 2012 was undertaken. Outcomes measured included patient demographics, stone size, degree of dilatation performed, success of stone extraction, number of procedures required for duct clearance and procedure‐related complications.
Results
One hundred and thirty‐six ERCPs were performed with balloon sphincteroplasty. One hundred and four had a previous sphincterotomy with a delayed balloon dilatation and 32 had sphincterotomy with immediate dilatation. The overall clearance rate of the common bile duct for immediate and delayed groups was 93% (28/30) and 93% (81/87), respectively. Bile duct clearance after the first procedure was achieved in 70% (21/30) of patients in the immediate group and 74% (64/87) in the delayed group. There were six complications in the delayed group and four in the immediate group. The most frequently used balloon size was 10 mm for both groups with mean sizes of 10.34 (2.93) and 11.73 (2.87) in the immediate and delayed groups, respectively.
Conclusion
Our study suggests that use of a combined approach is safe and effective and may provide benefits over using endoscopic balloon dilatation or endoscopic sphincterotomy alone in the treatment of choledocholithiasis. |
| doi_str_mv | 10.1111/ans.13058 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826623653</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1935895596</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3538-a78061aee8b669806b3249e894868d5275c5fb6b1f6972d5936cded064c935da3</originalsourceid><addsrcrecordid>eNp1kc1KxDAQx4Mofh98AQl40cNq0zRp4k3ELxA9qOeQplM30iY16bLuzUfwGX0So7uKCM5lhvCbH0P-CO2Q7JCkOtIuHhKaMbGE1klRsFFOZLm8mElB6RraiPEpywjnkq2itZyVggjG1tH0zNU-Gt9bg2M_ts4MEPzguxme2mH8661vdRxmuPEBD2PAnXb6ETpwA_YNNmPfQu0_W9qyOtp4jDWO1j228P76ZhIXAMNLD8GCM7CFVhrdRthe9E30cH52f3o5ur69uDo9uR4ZyqgY6VJknGgAUaXT01zRvJAgZCG4qFleMsOailek4bLMayYpNzXUGS-MpKzWdBPtz7198M8TiIPqbDTQttqBn0RFRM55TjmjCd37gz75SXDpOkWSTEjGJE_UwZwywccYoFF9sJ0OM0Uy9ZmGSmmorzQSu7swTqoO6h_y-_sTcDQHpraF2f8mdXJzN1d-AHo_lps</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1935895596</pqid></control><display><type>article</type><title>Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single‐centre experience</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><creator>Ho, Simon ; Rayzan, Daniel ; Fox, Adrian ; Kalogeropoulos, George ; Mackay, Sean ; Hassen, Sayed ; Banting, Simon ; Cade, Richard</creator><creatorcontrib>Ho, Simon ; Rayzan, Daniel ; Fox, Adrian ; Kalogeropoulos, George ; Mackay, Sean ; Hassen, Sayed ; Banting, Simon ; Cade, Richard</creatorcontrib><description>Background
Balloon dilatation of the ampulla at endoscopic retrograde cholangiopancreatography (ERCP) is increasingly utilized in the management of large bile duct stones. The aim of this study was to review and compare the outcomes of using endoscopic sphincterotomy with endoscopic balloon dilatation (sphincteroplasty) in a combined approach as a single‐stage (immediate) or a two‐stage procedure (delayed).
Methods
A retrospective review of medical records for all patients undergoing ERCP and balloon dilatation for choledocholithiasis between January 2010 and December 2012 was undertaken. Outcomes measured included patient demographics, stone size, degree of dilatation performed, success of stone extraction, number of procedures required for duct clearance and procedure‐related complications.
Results
One hundred and thirty‐six ERCPs were performed with balloon sphincteroplasty. One hundred and four had a previous sphincterotomy with a delayed balloon dilatation and 32 had sphincterotomy with immediate dilatation. The overall clearance rate of the common bile duct for immediate and delayed groups was 93% (28/30) and 93% (81/87), respectively. Bile duct clearance after the first procedure was achieved in 70% (21/30) of patients in the immediate group and 74% (64/87) in the delayed group. There were six complications in the delayed group and four in the immediate group. The most frequently used balloon size was 10 mm for both groups with mean sizes of 10.34 (2.93) and 11.73 (2.87) in the immediate and delayed groups, respectively.
Conclusion
Our study suggests that use of a combined approach is safe and effective and may provide benefits over using endoscopic balloon dilatation or endoscopic sphincterotomy alone in the treatment of choledocholithiasis.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.13058</identifier><identifier>PMID: 25781855</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Balloon treatment ; Bile ; Bile ducts ; Cholangiopancreatography, Endoscopic Retrograde - methods ; choledocholithiasis ; Choledocholithiasis - complications ; Choledocholithiasis - surgery ; Combined Modality Therapy - methods ; Complications ; Demographics ; Demography ; Digestive System Surgical Procedures - adverse effects ; Digestive System Surgical Procedures - methods ; endoscopic ; Endoscopy ; ERCP ; Female ; Humans ; Male ; Medical records ; Middle Aged ; Patients ; Postoperative Complications - physiopathology ; Retrospective Studies ; sphincteroplasty ; sphincterotomy ; Sphincterotomy - adverse effects ; Sphincterotomy - methods ; Sphincterotomy, Endoscopic - adverse effects ; Sphincterotomy, Endoscopic - methods ; Surgical outcomes ; Treatment Outcome</subject><ispartof>ANZ journal of surgery, 2017-09, Vol.87 (9), p.695-699</ispartof><rights>2015 Royal Australasian College of Surgeons</rights><rights>2015 Royal Australasian College of Surgeons.</rights><rights>2017 Royal Australasian College of Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-a78061aee8b669806b3249e894868d5275c5fb6b1f6972d5936cded064c935da3</citedby><cites>FETCH-LOGICAL-c3538-a78061aee8b669806b3249e894868d5275c5fb6b1f6972d5936cded064c935da3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.13058$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.13058$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25781855$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ho, Simon</creatorcontrib><creatorcontrib>Rayzan, Daniel</creatorcontrib><creatorcontrib>Fox, Adrian</creatorcontrib><creatorcontrib>Kalogeropoulos, George</creatorcontrib><creatorcontrib>Mackay, Sean</creatorcontrib><creatorcontrib>Hassen, Sayed</creatorcontrib><creatorcontrib>Banting, Simon</creatorcontrib><creatorcontrib>Cade, Richard</creatorcontrib><title>Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single‐centre experience</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background
Balloon dilatation of the ampulla at endoscopic retrograde cholangiopancreatography (ERCP) is increasingly utilized in the management of large bile duct stones. The aim of this study was to review and compare the outcomes of using endoscopic sphincterotomy with endoscopic balloon dilatation (sphincteroplasty) in a combined approach as a single‐stage (immediate) or a two‐stage procedure (delayed).
Methods
A retrospective review of medical records for all patients undergoing ERCP and balloon dilatation for choledocholithiasis between January 2010 and December 2012 was undertaken. Outcomes measured included patient demographics, stone size, degree of dilatation performed, success of stone extraction, number of procedures required for duct clearance and procedure‐related complications.
Results
One hundred and thirty‐six ERCPs were performed with balloon sphincteroplasty. One hundred and four had a previous sphincterotomy with a delayed balloon dilatation and 32 had sphincterotomy with immediate dilatation. The overall clearance rate of the common bile duct for immediate and delayed groups was 93% (28/30) and 93% (81/87), respectively. Bile duct clearance after the first procedure was achieved in 70% (21/30) of patients in the immediate group and 74% (64/87) in the delayed group. There were six complications in the delayed group and four in the immediate group. The most frequently used balloon size was 10 mm for both groups with mean sizes of 10.34 (2.93) and 11.73 (2.87) in the immediate and delayed groups, respectively.
Conclusion
Our study suggests that use of a combined approach is safe and effective and may provide benefits over using endoscopic balloon dilatation or endoscopic sphincterotomy alone in the treatment of choledocholithiasis.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Balloon treatment</subject><subject>Bile</subject><subject>Bile ducts</subject><subject>Cholangiopancreatography, Endoscopic Retrograde - methods</subject><subject>choledocholithiasis</subject><subject>Choledocholithiasis - complications</subject><subject>Choledocholithiasis - surgery</subject><subject>Combined Modality Therapy - methods</subject><subject>Complications</subject><subject>Demographics</subject><subject>Demography</subject><subject>Digestive System Surgical Procedures - adverse effects</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>endoscopic</subject><subject>Endoscopy</subject><subject>ERCP</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Postoperative Complications - physiopathology</subject><subject>Retrospective Studies</subject><subject>sphincteroplasty</subject><subject>sphincterotomy</subject><subject>Sphincterotomy - adverse effects</subject><subject>Sphincterotomy - methods</subject><subject>Sphincterotomy, Endoscopic - adverse effects</subject><subject>Sphincterotomy, Endoscopic - methods</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1KxDAQx4Mofh98AQl40cNq0zRp4k3ELxA9qOeQplM30iY16bLuzUfwGX0So7uKCM5lhvCbH0P-CO2Q7JCkOtIuHhKaMbGE1klRsFFOZLm8mElB6RraiPEpywjnkq2itZyVggjG1tH0zNU-Gt9bg2M_ts4MEPzguxme2mH8661vdRxmuPEBD2PAnXb6ETpwA_YNNmPfQu0_W9qyOtp4jDWO1j228P76ZhIXAMNLD8GCM7CFVhrdRthe9E30cH52f3o5ur69uDo9uR4ZyqgY6VJknGgAUaXT01zRvJAgZCG4qFleMsOailek4bLMayYpNzXUGS-MpKzWdBPtz7198M8TiIPqbDTQttqBn0RFRM55TjmjCd37gz75SXDpOkWSTEjGJE_UwZwywccYoFF9sJ0OM0Uy9ZmGSmmorzQSu7swTqoO6h_y-_sTcDQHpraF2f8mdXJzN1d-AHo_lps</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>Ho, Simon</creator><creator>Rayzan, Daniel</creator><creator>Fox, Adrian</creator><creator>Kalogeropoulos, George</creator><creator>Mackay, Sean</creator><creator>Hassen, Sayed</creator><creator>Banting, Simon</creator><creator>Cade, Richard</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201709</creationdate><title>Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single‐centre experience</title><author>Ho, Simon ; Rayzan, Daniel ; Fox, Adrian ; Kalogeropoulos, George ; Mackay, Sean ; Hassen, Sayed ; Banting, Simon ; Cade, Richard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-a78061aee8b669806b3249e894868d5275c5fb6b1f6972d5936cded064c935da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Balloon treatment</topic><topic>Bile</topic><topic>Bile ducts</topic><topic>Cholangiopancreatography, Endoscopic Retrograde - methods</topic><topic>choledocholithiasis</topic><topic>Choledocholithiasis - complications</topic><topic>Choledocholithiasis - surgery</topic><topic>Combined Modality Therapy - methods</topic><topic>Complications</topic><topic>Demographics</topic><topic>Demography</topic><topic>Digestive System Surgical Procedures - adverse effects</topic><topic>Digestive System Surgical Procedures - methods</topic><topic>endoscopic</topic><topic>Endoscopy</topic><topic>ERCP</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Postoperative Complications - physiopathology</topic><topic>Retrospective Studies</topic><topic>sphincteroplasty</topic><topic>sphincterotomy</topic><topic>Sphincterotomy - adverse effects</topic><topic>Sphincterotomy - methods</topic><topic>Sphincterotomy, Endoscopic - adverse effects</topic><topic>Sphincterotomy, Endoscopic - methods</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ho, Simon</creatorcontrib><creatorcontrib>Rayzan, Daniel</creatorcontrib><creatorcontrib>Fox, Adrian</creatorcontrib><creatorcontrib>Kalogeropoulos, George</creatorcontrib><creatorcontrib>Mackay, Sean</creatorcontrib><creatorcontrib>Hassen, Sayed</creatorcontrib><creatorcontrib>Banting, Simon</creatorcontrib><creatorcontrib>Cade, Richard</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ho, Simon</au><au>Rayzan, Daniel</au><au>Fox, Adrian</au><au>Kalogeropoulos, George</au><au>Mackay, Sean</au><au>Hassen, Sayed</au><au>Banting, Simon</au><au>Cade, Richard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single‐centre experience</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2017-09</date><risdate>2017</risdate><volume>87</volume><issue>9</issue><spage>695</spage><epage>699</epage><pages>695-699</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
Balloon dilatation of the ampulla at endoscopic retrograde cholangiopancreatography (ERCP) is increasingly utilized in the management of large bile duct stones. The aim of this study was to review and compare the outcomes of using endoscopic sphincterotomy with endoscopic balloon dilatation (sphincteroplasty) in a combined approach as a single‐stage (immediate) or a two‐stage procedure (delayed).
Methods
A retrospective review of medical records for all patients undergoing ERCP and balloon dilatation for choledocholithiasis between January 2010 and December 2012 was undertaken. Outcomes measured included patient demographics, stone size, degree of dilatation performed, success of stone extraction, number of procedures required for duct clearance and procedure‐related complications.
Results
One hundred and thirty‐six ERCPs were performed with balloon sphincteroplasty. One hundred and four had a previous sphincterotomy with a delayed balloon dilatation and 32 had sphincterotomy with immediate dilatation. The overall clearance rate of the common bile duct for immediate and delayed groups was 93% (28/30) and 93% (81/87), respectively. Bile duct clearance after the first procedure was achieved in 70% (21/30) of patients in the immediate group and 74% (64/87) in the delayed group. There were six complications in the delayed group and four in the immediate group. The most frequently used balloon size was 10 mm for both groups with mean sizes of 10.34 (2.93) and 11.73 (2.87) in the immediate and delayed groups, respectively.
Conclusion
Our study suggests that use of a combined approach is safe and effective and may provide benefits over using endoscopic balloon dilatation or endoscopic sphincterotomy alone in the treatment of choledocholithiasis.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>25781855</pmid><doi>10.1111/ans.13058</doi><tpages>5</tpages></addata></record> |
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| source | Wiley-Blackwell Journals; MEDLINE |
| subjects | Adult Aged Aged, 80 and over Balloon treatment Bile Bile ducts Cholangiopancreatography, Endoscopic Retrograde - methods choledocholithiasis Choledocholithiasis - complications Choledocholithiasis - surgery Combined Modality Therapy - methods Complications Demographics Demography Digestive System Surgical Procedures - adverse effects Digestive System Surgical Procedures - methods endoscopic Endoscopy ERCP Female Humans Male Medical records Middle Aged Patients Postoperative Complications - physiopathology Retrospective Studies sphincteroplasty sphincterotomy Sphincterotomy - adverse effects Sphincterotomy - methods Sphincterotomy, Endoscopic - adverse effects Sphincterotomy, Endoscopic - methods Surgical outcomes Treatment Outcome |
| title | Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single‐centre experience |
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