Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Endosc. May 16, 2012; 4(5): 180-184
Published online May 16, 2012. doi: 10.4253/wjge.v4.i5.180
Endoscopic papillary large balloon dilation after limited sphincterotomy for difficult biliary stones
Ana Rebelo, Pedro Moutinho Ribeiro, António Pinto Correia, José Cotter
Ana Rebelo, Pedro Moutinho Ribeiro, António Pinto Correia, José Cotter, Gastroenterology Department, Centro Hospitalar do Alto Ave, 4835 044 Guimarães, Portugal
Author contributions: Rebelo A and Ribeiro PM contributed equally to this work; Ribeiro PM and Correia AP designed the research; Rebelo A, Ribeiro PM, Correia AP and Cotter J performed the research; Rebelo A and Ribeiro PM analysed the data; Rebelo A wrote the paper; Ribeiro PM, Correia AP and Cotter J revised and corrected the paper.
Correspondence to: Ana Rebelo, MD, Gastroenterology Department, Centro Hospitalar do Alto Ave, Guimarães, Rua dos Cutileiros-Creixomil. 4835 044 Guimarães, Portugal. airebelo_@hotmail.com
Telephone: +351-253-540330 Fax: +351-253-421308
Received: June 26, 2011
Revised: November 16, 2011
Accepted: April 27, 2012
Published online: May 16, 2012
Abstract

AIM: To assess the efficacy and safety of endoscopic papillary large balloon dilation after biliary sphincterotomy for difficult bile duct stones retrieval.

METHODS: Retrospective review of consecutive patients submitted to the technique during 18 mo. The main outcomes considered were: efficacy of the procedure (complete stone clearance; number of sessions; need of lithotripsy) and complications.

RESULTS: A total of 30 patients with a mean age of 68 ± 10 years, 23 female (77%) and 7 male (23%) were enrolled. In 10 patients, a single stone was found in the common bile duct (33%) and in 20 patients multiple stones (67%) were found. The median diameter of the stones was 17 mm (12-30 mm). Dilations were performed with progressive diameter Through-The-Scope balloons (up to 12, 15) or 18 mm. Complete retrieval of stones was achieved in a single session in 25 patients (84%) and in two sessions in 4 patients (13%). Failure occurred in 1 case (6%). Mechanical lithotripsy was performed in 6 cases (20%). No severe complications occurred. One patient (3%) had mild-grade post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.

CONCLUSION: Endoscopic balloon dilatation with a large balloon after endoscopic sphincterotomy is a safe and effective technique that could be considered an alternative choice in therapeutic ERCP.

Keywords: Balloon dilation; Cholelithiasis; Endoscopic retrograde cholangiopancreatography; Lithotripsy; Sphincterotomy