title: Efficacy and safety of double-balloon endoscopy-assisted endoscopic papillary large-balloon dilatation for common bile duct stone removal.
abstract: BACKGROUND
  Endoscopic retrograde cholangiopancreatography is difficult to perform in patients with gastrointestinal tract reconstruction.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of double-balloon endoscopy-assisted endoscopic papillary large-balloon dilatation for common bile duct stones in patients with gastrointestinal tract reconstruction.
  
  
  METHODS
  We conducted a retrospective case series with a comparison to historical controls. During the period 2009-2013, 11 postoperative patients underwent endoscopic papillary large-balloon dilatation (Group A). Procedure efficacy and safety were compared with patients who underwent endoscopic sphincterotomy without endoscopic papillary large-balloon dilatation, who served as historical controls (Group B).
  
  
  RESULTS
  Group A consisted of 11 patients (63.6% males, mean age 78±10 years), and Group B consisted of 32 patients (78.1% males, mean age 75±7 years). The stone clearance rate was significantly higher in Group A than in Group B (100% vs. 65.6%, respectively; p<0.05). Median procedure time was significantly shorter in Group A than in Group B (54min vs. 102min, respectively; p<0.05), and the complication rate was not significantly different between groups (18% vs. 15.6%, respectively; p=0.586).
  
  
  CONCLUSIONS
  Endoscopic papillary large-balloon dilatation may be an effective and safe treatment procedure in patients with gastrointestinal tract reconstruction.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Japan. Electronic address: shuoana@iwate-med.ac.jp.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Oana
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Shibata
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Matsuda
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods*; D003135:Common Bile Duct / Q000473:pathology / Q000601:surgery*; D004106:Dilatation / Q000295:instrumentation*; D058582:Double-Balloon Enteroscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D041981:Gastrointestinal Tract / Q000473:pathology*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods; D016896:Treatment Outcome
keywords: Double-balloon endoscopy; Endoscopic papillary large-balloon dilatation; Endoscopic retrograde cholangiopancreatography; Roux-en-Y reconstruction