Conflict of interest: None.
Endoscopic papillary large-balloon dilation following limited sphincterotomy for the removal of refractory bile duct stones: Experience of 169 cases in a single Chinese center
Article first published online: 18 FEB 2013
© 2012 The Authors. Journal of Digestive Diseases © 2012 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd
Journal of Digestive Diseases
Volume 14, Issue 3, pages 125–131, March 2013
How to Cite
Yang, X. M., Hu, B., Pan, Y. M., Gao, D. J., Wang, T. T., Wu, J. and Ye, X. (2013), Endoscopic papillary large-balloon dilation following limited sphincterotomy for the removal of refractory bile duct stones: Experience of 169 cases in a single Chinese center. Journal of Digestive Diseases, 14: 125–131. doi: 10.1111/1751-2980.12013
- Issue published online: 18 FEB 2013
- Article first published online: 18 FEB 2013
- Accepted manuscript online: 21 NOV 2012 02:10AM EST
- balloon dilation;
- bile duct stone;
- endoscopic retrograde;
To evaluate the efficacy and safety of endoscopic papillary large-balloon dilation (EPLBD) combined with limited endoscopic sphincterotomy (EST) for the removal of large biliary duct stones (≥10 mm).
Data of patients who underwent an attempted removal of large bile duct stones by limited EST followed by EPLBD (≥12 mm in diameter) from April 2006 to October 2011 in our center were reviewed. Clinical characteristics, endoscopic methods and outcomes of the patients were collected and analyzed.
A total of 169 patients with a mean age of 69.3 years (range 19–97 years) underwent 171 procedures. Median stone size and balloon diameter was 15 mm and 13 mm, respectively. Complete stone removal in a single session was achieved in 163 procedures (95.3%) with mechanical lithotripsy (ML) used in 66 (38.6%). Patients with a larger stone size required more frequent use of ML with a comparable success rate (P < 0.01). There were no significant differences between patients with and without periampullary diverticula in stone clearance (97.3% vs 93.8%), ML requirement (36.5% vs 40.2%) and complications (2.7% vs 6.2%) (all P > 0.05). Seven patients had eight procedure-related complications including moderate or mild bleeding (n = 4), minor perforation (n = 1), mild pancreatitis (n = 2) and cholangitis (n = 1).
EPLBD following limited EST is an effective and safe approach for the removal of large biliary duct stones, especially for those refractory cases.