| Theme | Current Treatment Strategies for Common Bile Duct Stones | |
|---|---|---|
| Title | Endoscopic Papillary Balloon Dilatation (EPBD) with Isosorbide Dinitrate (ISDN) | |
| Publish Date | 2001/08 | |
| Author | Hiroshi Nakagawa | Gastrointestinal Unit, Komaki City Hospital |
| Author | Kenichi Takano | Gastrointestinal Unit, Komaki City Hospital |
| Author | Kazuo Isobe | Gastrointestinal Unit, Komaki City Hospital |
| Author | Akihiro Miyata | Gastrointestinal Unit, Komaki City Hospital |
| Author | Naohiko Iizuka | Gastrointestinal Unit, Komaki City Hospital |
| Author | Kazuo Hara | Gastrointestinal Unit, Komaki City Hospital |
| Author | Mutsumi Murayama | Gastrointestinal Unit, Komaki City Hospital |
| Author | Jyun Goto | Gastrointestinal Unit, Komaki City Hospital |
| Author | Eizaburo Ohno | Gastrointestinal Unit, Komaki City Hospital |
| Author | Hideko Ohshima | Gastrointestinal Unit, Komaki City Hospital |
| [ Summary ] | We devised a method of endoscopic papillary balloon dilatation (EPBD) to prevent acute pancreatitis. We performed EPBD for bile duct stones on 190 patients, using 4 different methods; group 1 (n=25): 8 atmospheres (atm) for 4 minutes without isosor bide dinitrate (ISDN), group 2 (n=38): 6 atm for 3 minutes with ISDN, group 3 (n=49): 4 atm 4 minutes with ISDN and group 4 (n=78): 3 atm 2 minutes with ISDN. Acute pancreatitis occurred in only 0.6% treated with EPBD, using ISDN. The rates of duct clearance were 88% in group 1, 97% in group 2, and 100% in groups 3 and 4. Presently EPBD that is performed most safely for group 4. The balloon began to dilate and open the passage at 1 atm with a notch sign a seen with a fluorogram and opened fully at 3 atm without a notch. We spent 2 minutes going from 0 atm to 3 atm and deflated immediately after reaching 3 atm. This soft inflation prevents edema of the Vater papilla and acute pancreatitis. EPBD can be performed safely when gradually inflated, using low pressure in combination with ISDN. | |