Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital
2
School of Medicine, National Yang-Ming University
Objectives: Several studies evaluated the role of endoscopic retrograde cholangiopancreaticography with endoscopic sphincterotomy in acute biliary pancreatitis (ABP). No study investigated the efficacy and safety of endoscopic papillary balloon dilation (EPBD) in ABP. Methods: We retrospectively reviewed the data of patients with ABP who received EPBD from 2005 to 2012. Results: A total of 187 patients, including 75 female and 112 male, were enrolled. The mean age of the patients was 65.9 years. According to Ranson's score and/or CT severity index, 159 (85.0%) patients had mild pancreatitis. The mean time from admission to EPBD was 3.3 days. The cholangiogram revealed common bile duct (CBD) filling defects in 153 (81.8%) patients and the mean size was 7.1 mm. The mean size of dilating balloon was 10.6 mm. The mean duration of the dilating procedure was 4.3 min. Overall, 128 (68.4%) patients had stones retrieved from CBD. The rate of pancreatic duct enhancement was 51.3% (96/187). There were 5 (2.7%) adverse events, 3 (1.6%) intra-procedure bleeding incidents, and no procedure-related mortality. Serum bilirubin, amylase, and CRP significantly decreased after EPBD. The clinical outcomes were similar between 84 (44.9%) patients with and 103 (50.1%) without persistent cholestasis and/or concomitant cholangitis.Conclusion: EPBD can be helpful or at least does no harm for ABP.