November 12, 2014
Antiviral Agents/administration & dosage/*adverse effects/therapeutic use
Drug Therapy, Combination
Hepatitis C, Chronic/drug therapy
Interferon-alpha/administration & dosage/therapeutic use
Oligopeptides/administration & dosage/*adverse effects/therapeutic use
Polyethylene Glycols/administration & dosage/therapeutic use
Recombinant Proteins/administration & dosage/therapeutic use
Ribavirin/administration & dosage/therapeutic use
Notes: Selvi Sabater, P
Espuny Miro, A
Munoz Bertran, E D
Plaza Aniorte, J
Farm Hosp. 2013 May-Jun;37(3):269-70. doi: 10.7399/FH.2013.37.1.66.
Reference Type: Journal Article
Record Number: 5220Author: Seo, Y. R., Moon, J. H., Choi, H. J., Kim, D. C., Lee, T. H., Cha, S. W., Cho, Y. D., Park, S. H. and Kim, S. J.
Title: Papillary balloon dilation is not itself a cause of post-endoscopic retrograde cholangiopancreatography pancreatitis; results of anterograde and retrograde papillary balloon dilation
Journal: J Gastroenterol Hepatol
Short Title: Papillary balloon dilation is not itself a cause of post-endoscopic retrograde cholangiopancreatography pancreatitis; results of anterograde and retrograde papillary balloon dilation
Alternate Journal: Journal of gastroenterology and hepatology
ISSN: 1440-1746 (Electronic)
Accession Number: 23701518
Cholangiopancreatography, Endoscopic Retrograde/*adverse effects
Abstract: OBJECTIVES: The mechanism of pancreatitis development following endoscopic papillary balloon dilation (EPBD) remains unknown. Antegrade dilation with percutaneous transhepatic papillary balloon dilation (PTPBD) allows the removal of bile duct stones or fragments during percutaneous choledochoscopic lithotomy, with less mechanical trauma to the papilla than with EPBD-mediated stone removal. METHODS: A total of 56 patients with bile duct stones underwent antegrade dilation with PTPBD from March 2006 to February 2011. A total of 208 patients with common bile duct stones underwent retrograde dilation with EPBD during the same period. The conditions of papillary balloon dilation were identical in both groups. The frequencies of pancreatitis and hyperamylasemia were compared in both groups. RESULTS: Pancreatitis occurred in 14 (6.7%) of 208 patients in the EPBD group (mild, nine; moderate, four; severe, one). There was no case of pancreatitis among 56 patients in the PTPBD group (P < 0.05). Hyperamylasemia developed in significantly more patients treated in the EPBD group (62, 29.8%) compared with the PTPBD group (4, 7.1%; P < 0.05). Complete bile duct clearance was achieved in 98.2% of PTPBD group and 97.1% of EPBD group. CONCLUSIONS: The rates of post-procedural pancreatitis and hyperamylasemia were significantly higher after retrograde dilation with EPBD than after antegrade dilation with PTPBD for the removal of bile duct stones. Although the mechanism of pancreatitis following papillary balloon dilation remains unclear, post-EPBD pancreatitis may be associated with procedures before and after balloon dilation similar to mechanical lithotripsy rather than balloon dilation itself.