Endoscopic Papillary Balloon Dilation with Large Balloon after Limited Sphincterotomy for Retrieval of Choledocholithiasis
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TLDR
EBD with larger balloon seems to be a feasible and safe alternative technique for conventional EST in CBD stone extraction and any episodes of perforation, bleeding was not developed.Abstract:
Endoscopic papillary balloon dilation (EBD) for choledocholithiasis is known to be comparable to endoscopic sphincterotomy (EST) especially in cases of small stones. With larger stones, EBD with conventional balloon, which have a diameter of 6-8 mm, was reported as less effective for extraction of stones. We evaluated the efficacy and complications of EBD with large balloons (10-15 mm) after limited EST for retrieval of choledocholithiasis. From February 2005, we have performed EBD with limited EST for retrieval of common bile duct (CBD) stones. The patients who admitted with hyperamylasemia and gallstone pancreatitis were excluded. In cases without CBD dilation, EPBD with 12 mm for 40 seconds was performed. And in cases with CBD dilation, we dilated the sphincters with 15 mm sized balloon for 40 seconds. Total 22 patients (11 of male) were performed EBD with limited EST for retrieval of CBD stones. The median diameter of the stones was 10 mm (5-25 mm). Ten cases had multiple stones and 6 cases periampullary diverticuli. Successful stone removal in the initial session of ERCP with EBD was accomplished in 16 patients (72.7%). And complete retrieval of bile duct stones was achieved in all patients with repeated ERCP. In the aspect of complications, any episodes of perforation, bleeding was not developed. Only one case of mild grade of post-procedural pancreatitis was noted. However, post-procedural hyperamylasemia was developed in 16 cases (68.2%). EBD with larger balloon seems to be a feasible and safe alternative technique for conventional EST in CBD stone extraction.read more
Citations
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Journal ArticleDOI
Endoscopic large-balloon sphincteroplasty without preceding sphincterotomy for the removal of large bile duct stones: a preliminary study.
Seok Jeong,Sung-Ho Ki,Don Haeng Lee,Jung Il Lee,Jin-Woo Lee,Kye Sook Kwon,Hyung Gil Kim,Yong Woon Shin,Young Soo Kim +8 more
TL;DR: The data suggest that LBS without EST is safe and effective in patients with large bile duct stones.
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Large size balloon dilation of the ampulla after biliary sphincterotomy can facilitate endoscopic extraction of difficult bile duct stones.
TL;DR: Large size balloon dilation after biliary sphincterotomy is simple, safe, and highly effective technique that can greatly assist in the management of difficult to extract bile duct stones.
Journal ArticleDOI
Endoscopic papillary large balloon dilation for large common bile duct stones
Rajeev Attam,Martin L. Freeman +1 more
TL;DR: EPLBD would theoretically combine advantages of sphincterotomy and balloon dilation by increasing efficacy at stone extraction while minimizing complications of both EBS and EBD, and is a reasonable option for removal of large or difficult common bile duct stones.
Journal ArticleDOI
Endoscopic papillary large balloon dilation alone without sphincterotomy for the treatment of large common bile duct stones.
Hoi-Hung Chan,Hoi-Hung Chan,Kwok-Hung Lai,Chiun-Ku Lin,Wei-Lun Tsai,E-Ming Wang,Ping-I Hsu,Wen-Chi Chen,Hsien-Chung Yu,Huay-Min Wang,Feng-Woei Tsay,Cheng-Chung Tsai,I-Shu Chen,Yu-Chia Chen,Huei-Lung Liang,Huay-Ben Pan +15 more
TL;DR: 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.
Journal ArticleDOI
Endoscopic papillary large balloon dilation for the removal of bile duct stones
TL;DR: Recent accumulated results of EPLBD with or even without EST suggest that it is a safe and effective procedure for the removal of large or difficult bile duct stones without any additional risk of severe adverse events, when performed under appropriate guidelines.
References
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Endoscopic sphincterotomy complications and their management: an attempt at consensus
Peter B. Cotton,Glen A. Lehman,J. Vennes,J.E. Geenen,R.C.G. Russell,William C. Meyers,C. Liguory,N. Nickl +7 more
TL;DR: This document is an attempt to provide guidelines for prevention and management of complications, based on a workshop of selected experts, and a comprehensive review of the literature, that emphasize the importance of specialist training, disinfection, drainage, and collaboration with surgical colleagues.
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TL;DR: The rate of complications after endoscopic biliary sphincterotomy can vary widely in different circumstances and is primarily related to the indication for the procedure and to endoscopic technique, rather than to the age or general medical condition of the patients.
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Endoscopic sphincterotomy of the ampulla of Vater
TL;DR: Endoscopic sphincterotomy at the papilla of Vater, combining and modifying technics already established for retrograde cannulation and electrosurgical polypectomy, has been successfully performed in 2 patients with removal of stones impacted in the ampulla and proximal common bile duct.
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TL;DR: The rate of complications after endoscopic biliary sphincterotomy can vary widely in different circumstances and is primarily related to the indication for the procedure and to endoscopic technique, rather than to the age or general medical condition of the patient.
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