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Endoscopic papillary balloon dilation for bile duct stones in patients on hemodialysis

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Endoscopic papillary balloon dilation (EPBD) is a less hazardous alternative to endoscopic sphincterotomy for managing bile duct stones in patients with a coagulopathy. However, little information on EPBD is available for patients with bile duct stones who are undergoing hemodialysis (HD). We aimed to evaluate the safety and efficacy of EPBD for such patients.

Patients

This was a retrospective cohort study with prospectively collected data for 37consecutive patients with bile duct stones who were undergoing HD and who also underwent EPBD between December 1995 and April 2010 at four institutions in Tokyo, Japan. The main outcome was the safety and efficacy of EPBD for managing bile duct stones in patients undergoing HD.

Results

The bile duct stones were completely removed in one session in 24 patients (64.8%). Overall success was achieved using EPBD alone in all patients. Complications occurred in five patients (13.5%), including two with hemorrhage (5.4%). No hemorrhage developed in any of the 33 patients who had no additional bleeding risk except for HD. Pancreatitis and perforation developed in two (5.4%) and one (2.7%) patient, respectively.

Conclusions

EPBD seems to be a safe and effective treatment to extract bile duct stones in patients undergoing HD. However, EPBD should be performed carefully in patients with additional bleeding risk factors, such as Child–Pugh class C liver cirrhosis and those taking anti-platelet agents at the time of EPBD.

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Abbreviations

HD:

Hemodialysis

ERCP:

Endoscopic retrograde cholangiopancreatography

EPBD:

Endoscopic papillary balloon dilation

EST:

Endoscopic sphincterotomy

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Naminatsu Takahara, Hiroyuki Isayama, Takashi Sasaki, Naoki Sasahira, Suguru Mizuno, Kazumichi Kawakubo, Hirofumi Kogure, Natsuyo Yamamoto, Yousuke Nakai, Kenji Hirano, Minoru Tada & Kazuhiko Koike

  2. Department of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan

    Naminatsu Takahara & Nobuo Toda

  3. Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan

    Takeshi Tsujino

  4. Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan

    Suguru Mizuno

  5. Yamanashi Prefectural Hospital Organization, Yamanashi, Japan

    Masao Omata

Authors
  1. Naminatsu Takahara
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  2. Hiroyuki Isayama
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  3. Takashi Sasaki
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  4. Takeshi Tsujino
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  5. Nobuo Toda
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  6. Naoki Sasahira
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  7. Suguru Mizuno
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  8. Kazumichi Kawakubo
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  9. Hirofumi Kogure
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  10. Natsuyo Yamamoto
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  11. Yousuke Nakai
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  12. Kenji Hirano
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  13. Minoru Tada
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  14. Masao Omata
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  15. Kazuhiko Koike
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Corresponding author

Correspondence to Hiroyuki Isayama.

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Takahara, N., Isayama, H., Sasaki, T. et al. Endoscopic papillary balloon dilation for bile duct stones in patients on hemodialysis. J Gastroenterol 47, 918–923 (2012). https://doi.org/10.1007/s00535-012-0551-x

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  • DOI: https://doi.org/10.1007/s00535-012-0551-x

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