title: Twenty-Second versus Sixty-Second Dilation Duration in Endoscopic Papillary Balloon Dilation for the Treatment of Small Common Bile Duct Stones: A Prospective Randomized Controlled Multicenter Trial.
abstract: OBJECTIVE
  Endoscopic papillary balloon dilation (EPBD) has been advocated as an alternative therapy to endoscopic sphincterotomy for the treatment of common bile duct (CBD) stones. However, there is no established consensus on the optimal balloon dilation duration (BDD). We prospectively evaluated the efficacy and post-endoscopic retrograde cholangiopancreatography (ERCP) complications between the 20- and 60-second EPBD groups.
  
  
  METHODS
  A total of 228 patients with small CBD stones (≤12 mm) were randomly assigned to undergo EPBD with a 20- or 60-second duration at six institutions. We evaluated baseline patient characteristics, endoscopic data, clinical outcomes, and procedure-related complications. In addition, we analyzed risk factors for postprocedural pancreatitis.
  
  
  RESULTS
  CBD stones were removed successfully in 107 of 109 patients (98.1%) in the 20-second group and in 112 of 119 patients (94.1%) in the 60-second group (p=0.146). Post-ERCP pancreatitis developed in seven patients (6.4%) in the 20-second group and nine patients (7.5%) in the 60-second group (p=0.408). In multivariate analysis, contrast dye injection into the pancreatic duct is a significant risk factor for post-EPBD pancreatitis.
  
  
  CONCLUSIONS
  Based on the data showing that there were no significant differences in safety and efficacy between the two BDD groups, 20 seconds of BDD may be adequate for treatment of small CBD stones with EPBD.
authors: Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors: Byoung Wook
authors: BW
authors: Bang
authors: Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
authors: Tae Hoon
authors: TH
authors: Lee
authors: Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors: Tae Jun
authors: TJ
authors: Song
authors: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors: Joung-Ho
authors: JH
authors: Han
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors: Hyun Jong
authors: HJ
authors: Choi
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors: Jong Ho
authors: JH
authors: Moon
authors: Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors: Chang-Il
authors: CI
authors: Kwon
authors: Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors: Seok
authors: S
authors: Jeong
keywords: Cholangiopancreatography; Choledocholithiasis; Endoscopic retrograde; Pancreatitis