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

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

doi:10.1016/j.hbpd.2024.11.002

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

Hepatobiliary Pancreat Dis Int. 2024 Nov 12:S1499-3872(24)00132-2. doi: 10.1016/j.hbpd.2024.11.002. Online ahead of print.

Authors

Si-Huai Xiong¹, Yuan-Chen Wang², Ji-Yao Guo³, Lei Wang², Tian-Yu Shi², Liang-Hao Hu², Zhuan Liao², Wen-Bin Zou⁴

Affiliations

¹ Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; Shanghai Institute of Pancreatic Diseases, Shanghai 200000, China.
² Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; Shanghai Institute of Pancreatic Diseases, Shanghai 200000, China; Changhai Clinical Research Unit, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
³ Department of Gastroenterology, 984 Hospital of Joint Logistic Support Force, Beijing 100000, China.
⁴ Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; Shanghai Institute of Pancreatic Diseases, Shanghai 200000, China; Changhai Clinical Research Unit, Changhai Hospital, Naval Medical University, Shanghai 200433, China. Electronic address: dr.wenbinzou@hotmail.com.

PMID: 39580300
DOI: 10.1016/j.hbpd.2024.11.002

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.

Keywords: Balloon catheter; Basket catheter; Endoscopic retrograde cholangiopancreatography; Pancreatic stone; Stone extraction.