Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients

Background and aim There is paucity of data about endoscopic pancreatic sphincteroplasty (EPS) after endoscopic pancreatic sphincterotomy (EPST) in the treatment of chronic pancreatitis. The aim of this study was to establish the indications for EPS, complications related to it, and to examine its e...

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Main Authors: Rinkesh Kumar Bansal, Gaurav Kumar Patil, Rajesh Puri, Narendra S. Choudhary, Saurabh R. Patle, Zubin D. Sharma, Randhir Sud
Format: Article
Language:English
Published: Georg Thieme Verlag KG 2017-12-01
Series:Endoscopy International Open
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-119752
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author Rinkesh Kumar Bansal
Gaurav Kumar Patil
Rajesh Puri
Narendra S. Choudhary
Saurabh R. Patle
Zubin D. Sharma
Randhir Sud
author_facet Rinkesh Kumar Bansal
Gaurav Kumar Patil
Rajesh Puri
Narendra S. Choudhary
Saurabh R. Patle
Zubin D. Sharma
Randhir Sud
author_sort Rinkesh Kumar Bansal
collection DOAJ
description Background and aim There is paucity of data about endoscopic pancreatic sphincteroplasty (EPS) after endoscopic pancreatic sphincterotomy (EPST) in the treatment of chronic pancreatitis. The aim of this study was to establish the indications for EPS, complications related to it, and to examine its effectiveness in managing chronic pancreatitis after a year of follow-up. Methods We evaluated the safety and efficacy of pancreatic balloon dilation coupled with sphincterotomy for the treatment of chronic pancreatitis. The technical success rate of balloon dilation, stone clearance, frequency of pancreatic stenting, and procedure-related adverse events were recorded. Results Out of 580 patients who underwent pancreatic endotherapy between July 2014 and February 2016, 80 patients underwent EPS. The mean age of these 80 patients was 34 ± 11 years, and 80 % (n = 64) were males. The common indications were removal of large radiolucent stones in 31 patients; unyielding radiopaque stones post extracorporeal shock wave lithotripsy (ESWL) in 20 patients, and pancreatic duct stricture combined with stones in 29 patients. EPS could be successfully completed in 98.75 % of patients. Complete ductal clearance in a single session was achieved in only 25 patients, while 26 patients required two sessions. There were two adverse events of pain requiring admission for more than 24 hours and one procedure related bleeding, all of which were managed conservatively. The patients had an average follow-up of 8 months (6 – 12 months) and all the patients were pain free. Conclusions Endoscopic pancreatic sphincteroplasty is a relatively safe procedure with a low incidence of complications and a high rate of treatment success.
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spelling doaj.art-52548a68dce6417bb56e9a38a74932522022-12-22T01:38:32ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362017-12-010512E1229E123410.1055/s-0043-119752Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patientsRinkesh Kumar Bansal0Gaurav Kumar Patil1Rajesh Puri2Narendra S. Choudhary3Saurabh R. Patle4Zubin D. Sharma5Randhir Sud6Institute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, IndiaInstitute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, IndiaInstitute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, IndiaInstitute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, IndiaInstitute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, IndiaInstitute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, IndiaInstitute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, IndiaBackground and aim There is paucity of data about endoscopic pancreatic sphincteroplasty (EPS) after endoscopic pancreatic sphincterotomy (EPST) in the treatment of chronic pancreatitis. The aim of this study was to establish the indications for EPS, complications related to it, and to examine its effectiveness in managing chronic pancreatitis after a year of follow-up. Methods We evaluated the safety and efficacy of pancreatic balloon dilation coupled with sphincterotomy for the treatment of chronic pancreatitis. The technical success rate of balloon dilation, stone clearance, frequency of pancreatic stenting, and procedure-related adverse events were recorded. Results Out of 580 patients who underwent pancreatic endotherapy between July 2014 and February 2016, 80 patients underwent EPS. The mean age of these 80 patients was 34 ± 11 years, and 80 % (n = 64) were males. The common indications were removal of large radiolucent stones in 31 patients; unyielding radiopaque stones post extracorporeal shock wave lithotripsy (ESWL) in 20 patients, and pancreatic duct stricture combined with stones in 29 patients. EPS could be successfully completed in 98.75 % of patients. Complete ductal clearance in a single session was achieved in only 25 patients, while 26 patients required two sessions. There were two adverse events of pain requiring admission for more than 24 hours and one procedure related bleeding, all of which were managed conservatively. The patients had an average follow-up of 8 months (6 – 12 months) and all the patients were pain free. Conclusions Endoscopic pancreatic sphincteroplasty is a relatively safe procedure with a low incidence of complications and a high rate of treatment success.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-119752
spellingShingle Rinkesh Kumar Bansal
Gaurav Kumar Patil
Rajesh Puri
Narendra S. Choudhary
Saurabh R. Patle
Zubin D. Sharma
Randhir Sud
Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients
Endoscopy International Open
title Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients
title_full Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients
title_fullStr Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients
title_full_unstemmed Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients
title_short Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients
title_sort endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures experience in 80 patients
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-119752
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