Año 2019 / Volumen 111 / Número 12
Original
Endoscopic papillary large balloon dilation with minor sphincterotomy for periampullary diverticular papilla

935-940

DOI: 10.17235/reed.2019.6179/2019

Xiao-Dan Xu, Chun-Fang Xu, Jian-Qing Qian, Jian-Jun Dai, Zhen-Xing Sun,

Resumen
Background To observe the outcome of endoscopic papillary large balloon dilation (EPLBD) with minor sphincterotomy (mEST) for periampullary diverticular papilla related to stone removal. Methods Patients with confirmed periampullary diverticulum (PAD) during stone removal from May 2016 to April 2018 were reviewed retrospectively. The Chi-square test with Yates correction or Fisher’s exact test was used for the analysis of categorical data and a normality test was applied for continuous data. Results A total of 154 consecutive patients (89 males and 65 females, aged 51-87 years) with confirmed PAD during stone removal were included in the study. Cases were divided into the conventional EST group (n = 79) and the mEST plus EPLBD group (n = 75). The number of patients with an initial treatment success was greater in the EPLBD+mEST group compared with the EST group (96% vs 86.1%, p=0.03) and the procedure time for EPLBD+mEST was shorter than that for EST alone (46.1±13.7 min vs 53.3±11.6 min, p=0.01). The rate of complications in the EPLBD+mEST group was lower than in the EST group (17.3% vs 32.9%, p=0.04). When PAD was >15 mm, the initial success rate was higher (92.6% vs 73.9%, p=0.04) and the rate of overall complications was lower (14.8% vs 41.7%, p=0.03) in the EPLBD+mEST group than those in the EST group. Although, this was similar when PAD was <15 mm. Conclusion EPLBD+mEST might be safer and more effective than conventional EST alone for stone removal in the presence of PAD.
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Bibliografía
1. Lobo DN, Balfour TW, Iftikhar SY, et al. Periampullary diverticula and pancreaticobiliary disease. Br. J. Surg. 1999; 86:588–97. [PMID: 10361174 DOI: 10.1046/j.1365-2168.1999.01121.x]
2. Vaira D, Dowsett JF, Hatfield AR. Is duodenal diverticulum a risk factor for sphincterotomy? Gut 1989; 30: 939–42. [PMid:2503431 PMCid:PMC1434299DOI: 10.1136/gut.30.7.939]
3. Xun Li,Kexiang Zhu, Lei Zhang , et al. Periampullary Diverticulum May Be an Important Factor for the Occurrence and Recurrence of Bile Duct Stones. World J Surg (2012) 36:2666–2669. [PMid: 22911215 DOI: 10.1007/s00268-012-1716-8]
4. Lu Chen, Lu Xia, Yi Lu, et al. Influence of periampullary diverticulum on the occurrence of pancreaticobiliary diseases and outcomes of endoscopic retrograde cholangiopancreatography. European Journal of Gastroenterology & Hepatology 2017, 29:105–111. [PMid: 27606949 DOI: 10.1097/MEG.0000000000000744]
5. Boix J, Lorenzo-Zuniga V, Ananos F, et al. Impact of periampullary duodenal diverticula at endoscopic retrograde cholangiopancreatography: a proposed classification of periampullary duodenal diverticula. Surg. Laparosc.Endosc. Percutan. Tech. 2006; 16: 208–11. [PMid: 16921297 DOI: 10.1097/00129689-200608000-00002]
6. Egawa N, Kamisawa T, Tu Y, Sakaki N, Tsuruta K, Okam et al oto A.The role of juxtapapillary duodenal diverticulum in the formation of gallbladder stones. Hepatogastroenterology 1998; 45: 917–20.[ PMid:9755980]
7. Christoforidis E, Goulimaris I, Kanellos I, et al. The role of juxtapapillary duodenal diverticula in biliary stone disease. Gastrointest. Endosc. 2002; 55: 543–7. [PMid: 11923769 DOI: 10.1067/mge.2002.122615]
8. Tham TC, Kelly M. Association of periampullary duodenal diverticula with bile duct stones and with technical success of endoscopic retrograde cholangiopancreatography. Endoscopy 2004;36: 1050–1053. [PMid: 15578293 DOI: 10.1055/s-2004-826043]
9. Wu SD, Su Y, Fan Y .Relationship between intraduodenal peri-ampullary diverticulum and biliary disease in 178 patients undergoing ERCP. Hepatobiliary Pancreat. Dis. Int. 2007; 6:299–302. [PMid: 17548255]
10. Kim MH, Myung SJ, Seo DW, et al. Association of periampullary diverticula with primary choledocholithiasis but not with secondary choledocholithiasis. Endoscopy 1998; 30: 601–4 [PMid: 9826137 DOI: 10.1055/s-2007-1001363]
11. Shemesh E, Klein E, Czerniak A, et al. Endoscopic sphincterotomy in patients with gallbladder in situ: the influence of periampullary duodenal diverticula. Surgery 1990; 107: 163¬166.[ PMID:2099745]
12. Lotveit T, Skar V, Osnes M, et al. Juxtapapillary duodenal diverticula. Endoscopy 1988; 20 (Suppl. 1): 175–8. [PMid: 3139398 DOI: 10.1055/s-2007-1018171]
13. Zoepf T, Zoepf DS, Arnold JC, et al. The relationship between juxtapapillary duodenal diverticula and disorders of the biliopancreatic system: analysis of 350 patients. Gastrointest Endosc 2001; 54: 56-61.[ PMID:11427842 DOI:10.1067/mge.2001.115334]
14. Myung DS, Park CH, Koh HR, et al. Cap¬assisted ERCP in patients with difficult cannulation due to periampullary diverticulum. Endoscopy 2014; 46: 352¬355.[ PMID: 24549783 DOI: 10.1055/s-0034-1365060]
15. Huang CH, Tsou YK, Lin CH, et al. Endoscopic retrograde cholangiopancreatography (ERCP) for intradiverticular papilla:endoclip-assisted biliary cannulation. Endoscopy 2010; 42 Suppl 2:E223-E224.[ PMID: 20931451 DOI: 10.1055/s-0029-1215008]
16. Liu F, Li F, Zhou Y, et al. Minor endoscopic sphincterotomy plus endoscopic balloon dilation is an effective and safer alternative for endoscopic sphincterotomy during ERCP in patients with periampullary diverticula and bile duct stones. Gastrointest Endosc 2008; 67:AB230. [DOI: 10.1016/j.gie.2008.03.583]
17. Kim HG, Cheon YK, Cho YD, et al. Small sphincterotomy combined with endoscopic papillary large balloon dilation versus sphincterotomy. World J Gastroenterol 2009; 15: 4298¬4304.[ PMID: 19750573 PMCID: PMC2744186]
18. Panteris V, Vezakis A, Filippou G, et al.Influence of juxtapapillary diverticula on the success or difficulty of
cannulation and complication rate. Gastrointest Endosc 2008;68:903–910. [PMid: 18635174 DOI: 10.1016/j.gie.2008.03.1092]
19. Cotton PB, Lehman G, Vennes J, et al,Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc 1991; 37:383–393. [DOI: 10.1016/S0016-5107(91)70740-2]
20. Cotton PB. Outcomes of endoscopy procedures: struggling towards definitions. Gastrointest Endosc 1994; 40:514–518. [DOI: 10.1016/S0016-5107(94)70228-4]
21. Suda K, Mizuguchi K, Matsumoto M (1983) A histopathological study on the etiology of duodenal diverticulum related to the fusion of the pancreatic anlage. Am J Gastroenterol.1983;78:335–338[PMid:6407301]
22. Chang Whan Kim, Jae Hyuck Chang, Ji Hun Kim, et al,Size and type of periampullary duodenal diverticula are associated with bile duct diameter and recurrence of bile duct stones, Journal of Gastroenterology and Hepatology 28 (2013) 893–898.[ PMid:23432035 DOI: 10.1111/jgh.12184]
23. Ahmed Youssef Altonbary, Monir Hussein Bahgat .Endoscopic retrograde cholangiopancreatography in periampullary diverticulum: The challenge of cannulation.World J Gastrointest Endosc 2016 March 25; 8(6): 282-287 . [ PMid:27014423 PMCid:PMC4804185 DOI: 10.4253/wjge.v8.i6.282]
24. Kim HW, Kang DH, Choi CW, et al, Limited
endoscopic sphincterotomy plus large balloon dilation for choledocholithiasis with periampullary diverticula. World J Gastroenterol 2010;16:4335–434 . [PMid:20818818 PMCid:PMC2937115 DOI: 10.3748/wjg.v16.i34.4335]
25. García-Cano J, Arana LT, Ayllón CJ, et al. Biliary sphincterotomy dilation for the extraction of difficult common bile duct stones. Rev Esp Enferm Dig. 2009;101:541-5. PubMed PMID: 19785493.
26. Freeman ML, Guda NM. ERCP cannulation: a review of reported techniques. Gastrointest Endosc 2005; 61: 112–125. [DOI: 10.1016/S0016-5107(04)02463-0]
27. Leung JW, Tu R. Mechanical lithotripsy for large bile duct stones. Gastrointest Endosc 2004;59:688-90. [DOI: 10.1016/S0016-5107(04)00174-9]
28. Shaw MJ, Mackie RD, Moore JP, et al. Results of a multicenter trial using a mechanical lithotripter for the treatment of large bile duct stones.Am J Gastroenterol 1993;88:730-3 .[ PMid:8480739]
29. Kim TH, Kim JH, Seo DW, et al.International consensus guidelines for endoscopic papillarylarge-balloon dilation.Gastrointest Endosc. 2016 Jan;83(1):37-47. [PMid:26232360 DOI: 10.1016/j.gie.2015.06.016]
30. Sotoudehmanesh R, Khatibian M, Kolahdoozan S, et al. Indomethacin may reduce the incidence and severity of acute pancreatitis after ERCP. Am J Gastroenterol.2007;102:978–983.
31. Elmunzer BJ, Scheiman JM, Lehman GA. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. N Engl J Med. 2012;366:1414–1422.
32. Baron TH, Harewood GC. Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: a metaanalysis of randomized, controlled trials. Am J Gastroenterol.2004;99:1455–1460.
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Xu X, Xu C, Qian J, Dai J, Sun Z. Endoscopic papillary large balloon dilation with minor sphincterotomy for periampullary diverticular papilla . 6179/2019


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Recibido: 17/01/2019

Aceptado: 15/07/2019

Prepublicado: 13/11/2019

Publicado: 05/12/2019

Tiempo de revisión del artículo: 172 días

Tiempo de prepublicación: 300 días

Tiempo de edición del artículo: 322 días


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