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Long-term Complications in Patients With Previous Endoscopic Papillary Large Balloon Dilation: a Nationwide Retrospective Study

6. november 2026 opdateret af: Andrea Anderloni, Fondazione IRCCS Policlinico San Matteo di Pavia

Endoscopic retrograde cholangiopancreatography (ERCP) using standard techniques successfully removes common bile duct stones in most cases, but in 10-15% of patients, complex stone features or challenging biliary anatomy require advanced methods such as Endoscopic Papillary Large Balloon Dilation (EPLBD). Although EPLBD effectively facilitates the removal of difficult stones, it disrupts the papillary orifice and removes the natural barrier between the duodenum and the biliary tract, potentially increasing the risk of bacterial translocation and ascending cholangitis. This study aims to evaluate the long-term outcomes (over one year) in patients undergoing EPLBD, focusing primarily on the incidence of post-procedure cholangitis and secondarily on the rate of recurrent choledocholithiasis.

Studieoversigt

Status

Rekruttering

Betingelser

Detaljeret beskrivelse

Common bile duct stones are still the most common indication for endoscopic retrograde cholangiopancreatogrphy (ERCP). In the majority of cases bile duct clearance is obtained with standard techniques such as the execution of endoscopic sphincterotomy and the use of baskets and balloon catheters for bile duct stones extraction. In up to 10-15% of the cases, conventional techniques are unsuccessful defining the condition of difficult bile duct stones. The reason for a failed bile stones extraction is usually related to specific stone characteristics such as size, number, shape, consistency, location of the stone or certain biliary anatomy (biliary variants, altered anatomy intrahepatic locations of the stones, impacted stone). In these situations, the standard ERCP techniques for stones extraction could not be sufficient and advanced techniques are needed in order to obtain bile duct clearance. These includes endoscopic papillary large balloon dilation (EPLBD), mechanical lithotripsy and/or cholangioscopic-assisted lithotripsy. EPLBD is performed with a balloon catheter at the level of the papilla Balloon dilation allows a controlled dilation of the papilla and a subsequent extraction of the stones with the standard extraction devices. It demonstrated in different studies a high efficacy for difficult bile duct extraction compared to endoscopic sphincterotomy alone. EPLBD cause a complete disruption of the papilla orifice with a significant open communication between the duodenal lumen and the biliary tract. The absence of an anatomical barrier between the bile tract and the duodenal lumen could cause the translocation of intestinal bacteria and/or contamination with food particles with the potential risk of ascending cholangitis.

Aim of our study is to evaluate the natural history of patients who underwent to EPLBD especially focused on the appearance of cholangitis and bile duct stones relapse during a long-term follow-up (> 1 year). The primary objective is to evaluate the incidence of cholangitis episodes after EPLBD during a follow-up period of at least of 1 year. The secondary objective is to evaluate choledocholithiasis recurrence during a follow-up period of at least 1 year.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

1000

Kontakter og lokationer

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Studiekontakt

Studiesteder

    • Pavia
      • Pavia, Pavia, Italien, 27100
        • Rekruttering
        • Fondazione IRCCS Policlinico San Matteo di Pavia
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

Patients with an indication for ERCP for difficult bile stones in 15% of cases and application of EPLBD in 80% of cases.

Beskrivelse

Inclusion Criteria:

  • All patients with a diagnosis of choledocholithiasis who underwent ERCP with EPLBD from January 2014 to March 2023 with complete bile duct stone clearance in one or multiple ERCP sessions will be included in the study.

Exclusion Criteria:

  • Patients with age less than 18 years old or with surgically altered anatomy or with orthotopic liver transplantation will be excluded from the study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: RETROSPECTIVE

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of cholangitis
Tidsramme: 12 months

evaluate the incidence of cholangitis episodes after EPLBD during a follow-up period of at least of 1 year.

12 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of ERCP
Tidsramme: 12 months

1-year cumulative incidence of ERCP performed for bile duct stones relapse.

12 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

15. januar 2025

Primær færdiggørelse (Faktiske)

30. september 2026

Studieafslutning (Anslået)

1. december 2026

Datoer for studieregistrering

Først indsendt

6. november 2026

Først indsendt, der opfyldte QC-kriterier

6. november 2026

Først opslået (Faktiske)

12. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

6. november 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • Wide

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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