Endoscopic Papillary Balloon Dilation Can Be Safely Performed in Patients on Dual Antiplatelet Therapy: A Pilot Study

Authors

  • Sakue Masuda Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Ryuhei Jinushi Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Kazuya Koizumi Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Makomo Makazu Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Takashi Nishino Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Kento Shionoya Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Karen Kimura Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Chihiro Sumida Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Jun Kubota Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Chikamasa Ichita Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Akiko Sasaki Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Masahiro Kobayashi Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Makoto Kako Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa, Japan
  • Haruki Uojima Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Kanagawa, Japan
  • Ayumu Sugitani Department of the Institute of Biomedical Research, Sapporo Higashi Tokushukai Hospital, Hokkaido, Japan

DOI:

https://doi.org/10.15403/jgld-4764

Keywords:

antiplatelet therapy, choledocholithotomy, common bile duct stones, endoscopic papillary balloon dilation, endoscopic retrograde cholangiopancreatography, thienopyridine, combination of two antiplatelet agents

Abstract

Background and Aims: Endoscopic papillary balloon dilation (EPBD), a low-risk procedure for bleeding, has
been suggested as an alternative to endoscopic sphincterotomy for papillary dilatation in patients undergoing
endoscopic stone removal who are at a higher risk of bleeding. Several guidelines recommend that combination
of two antiplatelet agents should be reduced to single antiplatelet therapy when endoscopic sphincterotomy
is performed. However, there is no evidence that EPBD affects the risk of bleeding in patients receiving a
combination of two antiplatelet agents; thus, we aimed to explore this problem.

Methods: We included 31 patients who underwent EPBD for common bile duct stones at our hospital from
May 2014 to August 2022 and received either a combination of two antiplatelet agents or single antiplatelet
therapy prior to the procedure. The group receiving a combination of two antiplatelet agents included patients
who underwent EPBT without antiplatelet therapy withdrawal or with a shorter withdrawal period than those
recommended by the guidelines.

Results: In the group that received a combination of two antiplatelet agents, one of the two antiplatelet
agents used was thienopyridine. No bleeding was observed after EPBD in this study. We did not find
any significant between-group differences in hemoglobin levels and rate of post-endoscopic retrograde
cholangiopancreatography pancreatitis.

Conclusions: In patients treated with a combination of two antiplatelet agents, EPBD could be safely performed
without bleeding. Therefore, future prospective studies are warranted.

Downloads

Published

2023-06-22

How to Cite

1.
Masuda S, Jinushi R, Koizumi K, Makazu M, Nishino T, Shionoya K, Kimura K, Sumida C, Kubota J, Ichita C, Sasaki A, Kobayashi M, Kako M, Uojima H, Sugitani A. Endoscopic Papillary Balloon Dilation Can Be Safely Performed in Patients on Dual Antiplatelet Therapy: A Pilot Study. JGLD [Internet]. 2023 Jun. 22 [cited 2026 May 13];32(2):216-21. Available from: https://mail.jgld.ro/jgld/index.php/jgld/article/view/4764

Issue

Vol. 32 No. 2: June 2023

Section

Original Article