title: A Novel Approach for Endoscopic Papillary Balloon Dilation with the Guidewire Left in the Pancreatic Duct to Ensure Pancreatic Stenting.
abstract: OBJECTIVE
  Endoscopic papillary balloon dilation (EPBD) was reported to be superior for preserving the function of the sphincter of Oddi and to cause fewer late complications than endoscopic sphincterotomy. If the early complication of post-EPBD pancreatitis can be prevented, EPBD might be useful as long-term outcomes. This study assessed the feasibility of a novel EPBD for the purpose of reliable post-EPBD pancreatic stenting.
  
  
  METHODS
  Among 1814 ER-CPs, in 17 patients undergoing biliary cannulation with pancreatic duct guidewire placement method, we performed EPBD with the guidewire left in the pancreatic duct by the two-devices-in-one-channel method. This approach employed in order to ensure pancreatic stenting.
  
  
  RESULTS
  Procedures were successfully performed without the guidewire displacement, and pancreatic stents were easily placed in all patients. Post-EPBD pancreatitis occurred in only 1 patient (5.9%), and the severity was mild. Asymptomatic hyperamylasemia occurred in 3 patients (17.6%). There were no other early complications. The mean serum amylase levels (mean ± SD) before, 1 day, and 2 days after procedure were 81.4 ± 61.9, 301.2 ± 273.0, and 220.0 ± 177.6 IU/L.
  
  
  CONCLUSIONS
  EPBD with a guidewire left in the pancreatic duct is useful method allowing reliable pancreatic stenting and may contribute to the prevention of pancreatitis.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Nakahara
authors.forename: Chiaki
authors.initials: C
authors.lastname: Okuse
authors.forename: Keigo
authors.initials: K
authors.lastname: Suetani
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Michikawa
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Kobayasi
authors.forename: Takehito
authors.initials: T
authors.lastname: Otsubo
authors.forename: Fumio
authors.initials: F
authors.lastname: Itoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D042883:Choledocholithiasis / Q000175:diagnosis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts; D010195:Pancreatitis; D011183:Postoperative Complications; D009803:Sphincter of Oddi / Q000601:surgery*; D015607:Stents