A Lauri

A Minami

B Persson

Cheng-chung Tsai

Chiun-Ku Lin

CL Cheng

E-Ming Wang

Feng-Woei Tsay

G Ersoz

Hoi-Hung Chan

Hsien-Chung Yu

Huay-Ben Pan

Huay-Min Wang

Huei-Lung Liang

I Yasuda

I-Shu Chen

JA Disario

JC Arnold

JH Heo

JJ Bergman

KH Lai

Kwok-Hung Lai

M Natsui

M Staritz

ML Freeman

N Fujita

P Vlavianos

PB Cotton

Ping-I Hsu

PM Mathuna

S Attasaranya

S Bang

S Jeong

SP Misra

WC Liao

Wei-Lun Tsai

Wen-Chi Chen

Y Komatsu

Y Ochi

YK Cheon

Yu-chia Chen

BMC Gastroenterology

English

PubMed

Springer - Publisher Connector

Endoscopic papillary large balloon dilation alone without sphincterotomy for the treatment of large common bile duct stones

Abstract
          
            Background
            Lethal pancreatitis has been reported after treatment for common bile duct stones using small endoscopic papillary balloon dilation.
          
          
            Methods
            We retrospectively evaluated the safety and efficacy of using large balloon dilation alone without the use of sphincterotomy for the treatment of large common bile duct stones in Kaohsiung Veterans General Hospital. Success rate of stone clearance, procedure-related adverse events and incidents, frequency of mechanical lithotripsy use, and recurrent stones were recorded.
          
          
            Results
            A total of 247 patients were reviewed in the current study. The mean age of the patients was 71.2 years. Most of them had comorbidities. Mean stone size was 16.4 mm. Among the patients, 132 (53.4%) had an intact gallbladder and 121 (49%) had a juxtapapillary diverticulum. The mean size of dilating balloon used was 13.2 mm. The mean duration of the dilating procedure was 4.7 min. There were 39 (15.8%) patients required the help of mechanical lithotripsy while retrieving the stones. The final success rate of complete retrieval of stones was 92.7%. The rate of pancreatic duct enhancement was 26.7% (66/247). There were 3 (1.2%) adverse events and 6 (2.4%) intra-procedure bleeding incidents. All patients recovered completely after conservative and endoscopic treatment respectively, and no procedure-related mortality was noted. 172 patients had a follow-up duration of more than 6 months and among these, 25 patients had recurrent common bile duct stones. It was significantly correlated to the common bile duct size (p = 0.036)
          
          
            Conclusions
            Endoscopic papillary large balloon dilation alone is simple, safe, and effective in dealing with large common bile duct stones in relatively aged and debilitated patients.
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Endoscopic papillary large balloon dilation alone without sphincterotomy for the treatment of large common bile duct stones

Abstract

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