Comparison of the efficacy and safety of basket catheters and balloon catheters for endoscopic pancreatic duct stone clearance.

IF 3.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Hepatobiliary & Pancreatic Diseases International Pub Date : 2024-11-12 DOI:10.1016/j.hbpd.2024.11.002

Si-Huai Xiong, Yuan-Chen Wang, Ji-Yao Guo, Lei Wang, Tian-Yu Shi, Liang-Hao Hu, Zhuan Liao, Wen-Bin Zou

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Abstract

Background: The choice of a basket or a balloon catheter during endoscopic retrograde cholangiopancreatography (ERCP) for the clearance of pancreatic duct stones in patients with chronic pancreatitis (CP) remains controversial. This study compared the efficacy and safety of these two devices for pancreatic duct stone extractions.

Methods: We compared the efficacy and safety of basket and balloon catheters for pancreatic stone extractions. We enrolled CP patients who underwent ERCP for the first time at Changhai Hospital, Naval Medical University between February 2012 and December 2021. After propensity score matching (1:1), 101 patients were included in each group. The primary outcome was the rate of pancreatic stone clearance. Secondary outcomes included the rate of adverse events during hospitalization, long-term pain relief, and quality of life after one year follow-up period.

Results: The rate of complete clearance was comparable between the two groups (86.1 % vs. 84.2 %, P = 0.692). In patients with stones ≥ 2 cm before extracorporeal shock wave lithotripsy (ESWL), the rate of complete clearance was significantly higher in the balloon catheter group when compared to the basket catheter group [100 % (19/19) vs. 70.0 % (14/20), P = 0.031]. In the multivariate analysis, ESWL prior to stone extraction was the only independent predictor of complete clearance [with ESWL 58.4 % (264/452) vs. without ESWL 41.6 % (188/452), odds ratio = 2.3, 95 % confidence interval: 1.2-4.3; P = 0.013]. No significant differences between groups were found regarding the rates of adverse events during hospitalization, quality of life, and pain relief after one year of follow-up.

Conclusions: Basket and balloon catheters showed similar efficacy and safety for pancreatic stone extractions. However, the balloon catheter was superior to the basket catheter if the pancreatic stone size was ≥ 2 cm before ESWL.

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比较篮式导管和球囊导管在内窥镜胰管结石清除术中的有效性和安全性。

背景：在内镜逆行胰胆管造影术（ERCP）中选择篮式导管还是球囊导管来清除慢性胰腺炎（CP）患者的胰管结石仍存在争议。本研究比较了这两种设备用于胰管取石的有效性和安全性：我们比较了篮式导管和球囊导管用于胰管取石的有效性和安全性。我们招募了 2012 年 2 月至 2021 年 12 月期间在海军军医大学附属长海医院首次接受 ERCP 的 CP 患者。经过倾向评分匹配（1:1）后，每组纳入 101 名患者。主要结果是胰腺结石清除率。次要结果包括住院期间不良事件发生率、长期疼痛缓解率以及一年随访后的生活质量：结果：两组患者的结石完全清除率相当（86.1% 对 84.2%，P = 0.692）。在体外冲击波碎石（ESWL）前结石≥2厘米的患者中，球囊导管组的完全清除率明显高于篮式导管组[100% (19/19) vs. 70.0% (14/20)，P = 0.031]。在多变量分析中，取石前进行 ESWL 是完全清除结石的唯一独立预测因素 [使用 ESWL 的 58.4% (264/452) vs. 未使用 ESWL 的 41.6% (188/452)，几率比 = 2.3，95% 置信区间：1.2-4.3；P = 0.013]。在住院期间的不良事件发生率、生活质量以及随访一年后的疼痛缓解情况方面，各组之间没有发现明显差异：篮式导管和球囊导管在胰腺取石方面的疗效和安全性相似。结论：篮式和球囊导管在胰腺结石取出术中的疗效和安全性相似，但如果 ESWL 前胰腺结石大小≥ 2 厘米，则球囊导管优于篮式导管。

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来源期刊

Hepatobiliary & Pancreatic Diseases International 医学-胃肠肝病学

CiteScore

5.40

自引率

6.10%

发文量

152

审稿时长

3.0 months

期刊介绍： Hepatobiliary & Pancreatic Diseases International (HBPD INT) (ISSN 1499-3872 / CN 33-1391/R) a bimonthly journal published by First Affiliated Hospital, Zhejiang University School of Medicine, China. It publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatobiliary and pancreatic diseases. Papers cover the medical, surgical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas under the headings Liver, Biliary, Pancreas, Transplantation, Research, Special Reports, Editorials, Review Articles, Brief Communications, Clinical Summary, Clinical Images and Case Reports. It also deals with the basic sciences and experimental work. The journal is abstracted and indexed in SCI-E, IM/MEDLINE, EMBASE/EM, CA, Scopus, ScienceDirect, etc.