The Safety and Effectiveness of Medium Endoscopic Sphincterotomy with Endoscopic Papillary Large Balloon Dilation for Removing Difficult Common Bile Duct Stones.
- Author:
Sun Hae LEE
1
;
Sung Wook HONG
;
Young Deok CHO
;
Young Koog CHEON
;
Sang Gyun KIM
;
Jae Young JANG
;
Young Seok KIM
;
Jong Ho MOON
;
Joon Seong LEE
;
Moon Sung LEE
;
Chan Sup SHIM
;
Boo Sung KIM
Author Information
1. Department of Internal Medicine, Institute for Digestive Research, Soon Chun Hyang University College of Medicine, Seoul, Korea. csshim@hosp.sch.ac.kr
- Publication Type:Original Article
- Keywords:
Endoscopic papillary large balloon dilation;
Medium endoscopic sphincterotomy;
Bile duct stones
- MeSH:
Common Bile Duct*;
Hemorrhage;
Humans;
Lithotripsy;
Pancreatitis;
Sphincterotomy, Endoscopic*
- From:Korean Journal of Gastrointestinal Endoscopy
2007;35(2):80-86
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Mechanical lithotripsy is generally used when it is difficult to endoscopically remove common bile duct (CBD) stones. However, this procedure not only requires extensive experience, but it is also time consuming. Medium endoscopic sphincterotomy (medium EST) combined with endoscopic papillary large balloon dilation (EPLBD) is recently being increasingly used; therefore, the aim of this study was to evaluate the safety and effects of medium EST with EPLBD for patients with CBD stones that are difficult to remove. METHODS: 41 patients with CBD stones that were difficult to remove by conventional endoscopic methods were enrolled in this study. EPLBD was performed after medium EST. The size of the stones, the procedure time, complications and the total number of sessions needed for stone removal were analyzed. RESULTS: The mean size of the CBD stones was 18.2 +/- 7.7 mm, and the mean number of stones was 2.7. Additional mechanical lithotripsy for complete removal was required in 9.7% (4/41) of the patients. Procedure related complications occurred in 7% (3/41): bleeding in 1 case and acute pancreatitis in 2 cases. CONCLUSIONS: Medium EST with EPLBD was a safe and effective treatment modality for CBD stones that were difficult to remove. Further prospective randomized studies are needed for comparing the effectiveness and safety between conventional EST and medium EST with EPLBD for removing difficult CBD stones.
