Feasibility of a Novel Nonslip Short-Length Balloon Catheter for Endoscopic Papillary Balloon Dilation in Balloon Enteroscopy-Assisted ERCP: A Prospective Pilot Study (With Video).

Endoscopic papillary balloon dilation (EPBD) is an essential procedure, especially in balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP). However, the balloon often slips during the inflation process, and its length is often an impediment if the distance between the papilla and scope is limited or if stones are located close to the papilla. Therefore, this study aimed to examine the feasibility of a novel nonslip, short-length balloon catheter for EPBD in BE-ERCP. This prospective pilot study included 50 eligible patients who underwent BE-ERCP between December 2022 and October 2024. The study outcomes included the technical success and adverse event rates associated with EPBD using the novel balloon catheter in BE-ERCP. EPBD was successful in 100% (50/50) of the patients. Successful EPBD solely on the first inflation attempt without any slippage was achieved in 98% (49/50) cases; it was achieved in 100% (37/37) and 92% (12/13) of the procedures performed by experts and trainees, respectively, with no significant difference (p = 0.260). The incidence rate of adverse events was 4% (2/50). Two cases of mild pancreatitis occurred, which were treated conservatively. No stone entrapment between the balloon and the bile duct wall occurred in patients with choledocholithiasis. EPBD with the novel nonslip short-length balloon showed a low adverse event rate and a high success rate on the first attempt without slippage, which was maintained even when performed by trainees. This novel balloon offers a useful alternative to conventional balloons for EPBD during BE-ERCP.