{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:26:17Z","timestamp":1790886377658,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Endoscopic papillary large balloon dilation (EPLBD) is currently considered the first\u2010line treatment for difficult biliary stones (DBS). However, EPLBD alters the sphincter of Oddi's function, potentially exposing patients to cholangitis. To date, few data are available on the long\u2010term consequences of EPLBD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Methods<\/jats:title>\n                    <jats:p>The aim of this study is to explore the long\u2010term complications of EPLBD with endoscopic sphincterotomy (ES) in terms of cholangitis and biliary recurrence. Adult patients who underwent EPLBD with ES with complete bile duct clearance were included in the study. Primary outcome of the study was the rate of cholangitis; secondary outcome was biliary recurrence after EPLBD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1221 patients with a median age of 77\u2009years old (IQR 68\u201384) were included in the study. One hundred and forty\u2010three patients (11.7%) experienced at least one episode of cholangitis with a cumulative 1\u2010, 3\u2010, and 5\u2010year risk of cholangitis of 7.3%, 13.2%, and 15.3%, respectively. Cholangitis was caused by stones recurrence in 71.6% of cases, whereas alithiasic cholangitis was experienced in 22.9% of patients. The estimated 1\u2010, 3\u2010, and 5\u2010year risk of biliary recurrence was 9.7%, 16.7%, and 21.8%, respectively. In multivariate cox regression analysis, \u2265\u20092 previous ERCPs before EPLBD were independently associated with increased risk of cholangitis and biliary recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cholangitis and biliary recurrence are not an infrequent complication after EPLBD. Biliary stone recurrence may be a consequence of SO dysfunction after EPLBD with ES; further comparative data are needed to evaluate whether EPLBD with ES is directly associated with long\u2010term complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.70204","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:16:04Z","timestamp":1782299764000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010Term Outcomes After Endoscopic Papillary Large Balloon Dilation With Endoscopic Sphincterotomy for Difficult Biliary Stones: A Multicenter Retrospective Longitudinal Study"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8475-5464","authenticated-orcid":false,"given":"Aurelio","family":"Mauro","sequence":"first","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit Fondazione I.R.C.C.S. Policlinico San Matteo  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgenija","family":"Lozova","sequence":"additional","affiliation":[{"name":"HUS Abdominal Center, Endoscopy Department University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7280-1761","authenticated-orcid":false,"given":"Giuseppe","family":"Vanella","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational &amp; Clinical Research Center IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Spadaccini","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital\u2010IRCCS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7051-5432","authenticated-orcid":false,"given":"Davide","family":"Scalvini","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit Fondazione I.R.C.C.S. Policlinico San Matteo  Pavia Italy"},{"name":"Department of Internal Medicine and Medical Therapy University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8623-7428","authenticated-orcid":false,"given":"Vincenzo","family":"Occhipinti","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Internal Medicine Department ASST Papa Giovanni XXIII  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8758-654X","authenticated-orcid":false,"given":"Germana","family":"De Nucci","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit Aziende Socio Sanitaria Territoriale Rhodense  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1148-9684","authenticated-orcid":false,"given":"Cecilia","family":"Binda","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec\u2010Cesena Hospitals AUSL Romagna  Forl\u00ec Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7724-7402","authenticated-orcid":false,"given":"Andrea","family":"Lisotti","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Hospital of Imola University of Bologna  Imola Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Rainio","sequence":"additional","affiliation":[{"name":"HUS Abdominal Center, Endoscopy Department University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Aragona","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit Guglielmo da Saliceto Hospital  Piacenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Venezia","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Azienda Ospedaliera S.Croce e Carle  Cuneo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora","family":"Berretti","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Azienda Sanitaria Universitaria Friuli Centrale  Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6327-563X","authenticated-orcid":false,"given":"Giovanna Del Vecchio","family":"Blanco","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Desideri","sequence":"additional","affiliation":[{"name":"Gastroenterology Department San Maurizio Hospital  Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1935-7443","authenticated-orcid":false,"given":"Giuseppe","family":"Fierro","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit Aziende Socio Sanitaria Territoriale Rhodense  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Forti","sequence":"additional","affiliation":[{"name":"Digestive and Interventional Endoscopy Unit Ospedale Ca' Granda Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Franchellucci","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital\u2010IRCCS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Grassia","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit Azienda Socio\u2010Sanitaria Territoriale (ASST) Cremona  Cremona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Marzocca","sequence":"additional","affiliation":[{"name":"Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational &amp; Clinical Research Center IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9068-3209","authenticated-orcid":false,"given":"Stefano","family":"Mazza","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit Fondazione I.R.C.C.S. 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