{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:35:46Z","timestamp":1790249746959,"version":"4.1.0"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Endoscopic papillary large balloon dilation (EPLBD) has been increasingly used for the management of large common bile duct (CBD) stones. Although EPLBD is often preceded by endoscopic sphincterotomy (EST), EPLBD alone without EST has been increasingly reported as an alternative to EST for large CBD stones.<\/jats:p><jats:p>\n          Methods\u2002This multicenter randomized trial was conducted at 19 Japanese institutions to compare the efficacy and safety of EPLBD alone versus EST for the removal of large (\u2265\u200a10\u200amm) CBD stones. The primary end point was complete stone removal in a single session. The secondary end points included: overall complete stone removal, lithotripsy use, procedure time, adverse events, and cost.<\/jats:p><jats:p>\n          Results\u2002171 patients with large CBD stones were included in the analysis. The rate of single-session complete stone removal was significantly higher in the EPLBD-alone group than in the EST group (90.7\u200a% vs. 78.8\u200a%; P\u200a=\u200a0.04). Lithotripsy use was significantly less frequent in the EPLBD group than in the EST group (30.2\u200a% vs. 48.2\u200a%; P\u200a=\u200a0.02). The rates of early adverse events were comparable between the two groups: rates of overall adverse events were 9.3\u200a% vs. 9.4\u200a% and of pancreatitis were 4.7\u200a% vs. 5.9\u200a% in the EPLBD and EST groups, respectively. The procedure costs were $1442 vs. $1661 in the EPLBD and EST groups, respectively (P\u200a=\u200a0.12).<\/jats:p><jats:p>\n          Conclusion\u2002EPLBD without EST for the endoscopic treatment of large CBD stones achieved a significantly higher rate of complete stone removal in a single session compared with EST, without increasing adverse events.<\/jats:p>","DOI":"10.1055\/a-1145-3377","type":"journal-article","created":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T23:16:29Z","timestamp":1587078989000},"page":"736-744","source":"Crossref","is-referenced-by-count":36,"title":["Multicenter randomized trial of endoscopic papillary large balloon dilation without sphincterotomy versus endoscopic sphincterotomy for removal of bile duct stones: MARVELOUS trial"],"prefix":"10.1055","volume":"52","author":[{"given":"Hirofumi","family":"Kogure","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhei","family":"Kawahata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"},{"name":"Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Mukai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinpei","family":"Doi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan"},{"name":"Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Iwashita","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tesshin","family":"Ban","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nagoya Daini Red Cross Hospital, Nagoya, Japan"},{"name":"Department of Gastroenterology and Hepatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan"},{"name":"Department of Gastroenterology and Hepatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Sasahira","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tokyo Takanawa Hospital of Japan Community Health-care Organization, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Kubota","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Togawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironari","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Okabe","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Kurume University of Medicine, Kurume, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saburo","family":"Matsubara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Tokyo, Japan"},{"name":"Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Yagioka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Tokyo, Japan"},{"name":"Department of Gastroenterology, JR Tokyo General Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomotaka","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"},{"name":"Department of Gastroenterology, JR Tokyo General Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousuke","family":"Nakai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Isayama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"},{"name":"Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,4,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/00000658-199802000-00008","article-title":"Endoscopic sphincterotomy for stones by experts is safe, even in younger patients with normal ducts","volume":"227","author":"P B Cotton","year":"1998","journal-title":"Ann Surg"},{"issue":"S 01","key":"ref2","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1055\/s-2007-1021507","article-title":"Endoscopic papillary dilation (EPD) for the treatment of common bile duct stones and 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Fujita","year":"2003","journal-title":"Gastrointest Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1136\/gut.52.8.1165","article-title":"Endoscopic balloon dilatation versus endoscopic sphincterotomy for the removal of bile duct stones: a prospective randomised trial","volume":"52","author":"P Vlavianos","year":"2003","journal-title":"Gut"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1053\/j.gastro.2004.07.017","article-title":"Endoscopic balloon dilation compared with sphincterotomy for extraction of bile duct stones","volume":"127","author":"J A Disario","year":"2004","journal-title":"Gastroenterology"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1055\/s-2007-1005579","article-title":"Endoscopic papillary balloon dilation in cirrhotic patients: removal of common bile duct stones without sphincterotomy","volume":"28","author":"T 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Takahara","year":"2012","journal-title":"J Gastroenterol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1136\/gut.49.5.686","article-title":"Can endoscopic papillary balloon dilation really preserve sphincter of Oddi function?","volume":"49","author":"I Yasuda","year":"2001","journal-title":"Gut"},{"key":"ref13","first-page":"1787","article-title":"Preserved function of the Oddi sphincter after endoscopic papillary balloon dilation","volume":"50","author":"H Isayama","year":"2003","journal-title":"Hepatogastroenterology"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3109\/00365521.2013.848470","article-title":"Short- and long-term outcomes of endoscopic papillary large balloon dilation with or without sphincterotomy for removal of large bile duct stones","volume":"49","author":"H Kogure","year":"2014","journal-title":"Scand J Gastroenterol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.gie.2015.06.016","article-title":"International consensus guidelines for endoscopic papillary large-balloon dilation","volume":"83","author":"T H Kim","year":"2016","journal-title":"Gastrointest Endosc"},{"issue":"S 01","key":"ref16","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/den.13019","article-title":"Current endoscopic strategies for managing large bile duct stones","volume":"30","author":"B Doshi","year":"2018","journal-title":"Dig Endosc"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1111\/den.13029","article-title":"Japan Gastroenterological Endoscopy Society guidelines for endoscopic papillary large balloon dilation","volume":"30","author":"T Itoi","year":"2018","journal-title":"Dig Endosc"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1007\/s10620-012-2494-8","article-title":"Factors predictive of adverse 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duct stones in patients above 45 years of age","volume":"47","author":"M J Oh","year":"2012","journal-title":"Scand J Gastroenterol"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1471-230X-13-15","article-title":"Endoscopic large-balloon dilation alone versus endoscopic sphincterotomy plus large-balloon dilation for the treatment of large bile duct stones","volume":"13","author":"J C Hwang","year":"2013","journal-title":"BMC Gastroenterol"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1053\/j.gastro.2012.10.027","article-title":"Randomized trial of endoscopic sphincterotomy with balloon dilation versus endoscopic sphincterotomy alone for removal of bile duct stones","volume":"144","author":"A Y Teoh","year":"2013","journal-title":"Gastroenterology"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.12659\/MSM.894158","article-title":"A preliminary comparison of endoscopic sphincterotomy, endoscopic papillary large balloon dilation, and combination of the two in endoscopic choledocholithiasis treatment","volume":"21","author":"Y Guo","year":"2015","journal-title":"Med Sci Monit"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1055\/s-0043-114411","article-title":"Complete endoscopic sphincterotomy with vs. without large-balloon dilation for the removal of large bile duct stones: randomized multicenter study","volume":"49","author":"D Karsenti","year":"2017","journal-title":"Endoscopy"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1089\/lap.2016.0601","article-title":"Endoscopic papillary large balloon dilation versus endoscopic sphincterotomy for retrieval of large choledocholithiasis: a prospective randomized trial","volume":"27","author":"M A Omar","year":"2017","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.gie.2016.08.031","article-title":"Impact of endoscopic papillary large-balloon dilation on sphincter of Oddi function: a prospective randomized study","volume":"85","author":"Y K Cheon","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1055\/a-0639-5147","article-title":"Comparison of endoscopic papillary large balloon dilation with or without endoscopic sphincterotomy for the treatment of large bile duct stones","volume":"51","author":"J S Park","year":"2019","journal-title":"Endoscopy"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.gie.2014.06.005","article-title":"Risk factors for post-ERCP pancreatitis in wire-guided cannulation for therapeutic biliary ERCP","volume":"81","author":"Y Nakai","year":"2015","journal-title":"Gastrointest Endosc"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1016\/j.cgh.2012.05.017","article-title":"Balloon dilation with adequate duration is safer than sphincterotomy for extracting bile duct stones: a systematic review and meta-analyses","volume":"10","author":"W C Liao","year":"2012","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S2468-1253(19)30075-5","article-title":"Optimal dilation time for combined small endoscopic sphincterotomy and balloon dilation for common bile duct stones: a multicentre, single-blinded, randomised controlled trial","volume":"4","author":"W Meng","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/den.13031","article-title":"Comparison of late adverse events after endoscopic sphincterotomy versus endoscopic papillary large balloon dilation for common bile duct stones: A propensity score-based cohort analysis","volume":"30","author":"A Maruta","year":"2018","journal-title":"Dig Endosc"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/den.13220","article-title":"Endoscopic papillary large balloon dilation and endoscopic papillary balloon dilation both without sphincterotomy for removal of large bile duct stones: A propensity-matched analysis","volume":"31","author":"R Hakuta","year":"2019","journal-title":"Dig Endosc"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1145-3377.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T22:32:04Z","timestamp":1598481124000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1145-3377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,16]]},"references-count":36,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2020,8,26]]},"published-print":{"date-parts":[[2020,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1145-3377","relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,16]]}}}