title: Histological analysis of the papilla after endoscopic papillary balloon dilation.
abstract: OBJECTIVE
  Endoscopic papillary balloon dilation is an effective procedure in the management of bile duct stones and is believed to preserve the papillary function. The papillary architecture is also considered to be preserved. However, little is known about the effects of balloon dilation on papillary structure. The present study was conducted to elucidate these effects.
  
  
  METHODS
  Since May 1994, endoscopic papillary balloon dilation was performed in 467 patients (407 patients for removal of bile duct stone, 57 for insertion of stent and 3 for baby cholangioscope). Of those, histological examinations were undertaken in 10 patients. The indications of endoscopic papillary balloon dilation were bile duct stone removal in 2 patients, stent insertion in 8. The specimens were obtained 2 to 63 weeks after endoscopic papillary balloon dilation during surgical operation in 6 patients and autopsy in 4 patients. Serial sections through the papilla were stained by hematoxylin and eosin and Masson's trichrome. The specimens were also obtained from 4 patients without biliary disease as control.
  
  
  RESULTS
  No smooth muscle disruption nor architectural distortion was observed except for one patient who had mild disruption of smooth muscle caused by a biliary drainage tube. However, mild to moderate inflammation and fibrosis were seen in 9 patients and in 8, respectively.
  
  
  CONCLUSIONS
  The papillary architecture is not affected by endoscopic papillary balloon dilation. This may imply that endoscopic papillary balloon dilation preserves papillary function.
authors.affiliation: Department of Endoscopy and Endoscpic Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113 Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Kawabe
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Komatsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: T
authors.initials: T
authors.lastname: Takemura
authors.forename: Nobuo
authors.initials: N
authors.lastname: Toda
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Imai
authors.forename: Y
authors.initials: Y
authors.lastname: Shiratori
authors.forename: M
authors.initials: M
authors.lastname: Omata
mesh_terms: D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology*; D002404:Catheterization / Q000379:methods; D016145:Endoscopy, Digestive System; D005260:Female; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents