Endoscopic papillary large balloon dilation for bile duct stones in elderly patients

World J Clin Cases. 2015 Apr 16;3(4):353-9. doi: 10.12998/wjcc.v3.i4.353.

Abstract

Aim: To investigate whether endoscopic papillary large balloon dilation (EPLBD) can be safety and effectively performed in patients aged ≥ 80 years.

Methods: Lithotomy by EPLBD was conducted in 106 patients with bile duct stones ≥ 13 mm in size or with three or more bile duct stones ≥ 10 mm. The patients were divided into group A (< 80 years) and group B (≥ 80 years). Procedure success rate, number of endoscopic retrograde cholangiopancreatographies (ERCP), and incidence of complications were examined in both groups.

Results: Group B tended to include significantly more patients with peripapillary diverticulum, hypertension, hyperlipemia, cerebrovascular disease/dementia, respiratory disease/cardiac disease, and patients administered an anticoagulant or antiplatelet agent (P < 0.05). The success rate of the initial lithotomy was 88.7 (94/106)%. The final lithotomy rate was 100 (106/106)%. Complications due to treatment procedure occurred in 4.72 (5/106)% of the patients. There was no significant difference in procedure success rate, number of ERCP, or incidence of complications between group A and group B.

Conclusion: EPLBD can be safely performed in elderly patients, the same as in younger patients.

Keywords: Choledocholithiasis; Elderly patients; Endoscopic papillary large balloon dilation; Endoscopic sphincterotomy; Large bile duct stones.