Endoscopic Balloon Sphincteroplasty without Sphincterotomy for Removal of Common Bile Duct Stones.
- Author:
Don Haeng LEE
1
;
Si Young SONG
;
Jae Bock CHUNG
;
Chun Kun LEE
;
Se Joon LEE
;
Young Myung MOON
;
Jin Kyung KANG
;
In Suh PARK
Author Information
1. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Common bile duct stone;
Endoscopic balloon sphincteroplasty
- MeSH:
Abdominal Pain;
Bile Ducts;
Common Bile Duct*;
Dilatation;
Follow-Up Studies;
Hemorrhage;
Humans;
Nitroglycerin;
Pancreatitis;
Sepsis;
Sphincter of Oddi
- From:Korean Journal of Gastrointestinal Endoscopy
1998;18(3):333-339
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The complications associated with endoscopic stone removal arise from the sphincterotomy that is performed to facilitate stone extraction. Early complications such as bleeding, perforation, pancreatitis and sepsis occur in about 10% of all patients. Moreover late complications may emerge due to the loss of the sphincter function. So the endoscopic removal of the bile duct stones without a sphincterotomy seems preferable in order to avoid the early complications related to the sphincterotomy, and may also help to preserve the function of the sphincter of Cddi. AIM: To evaluate the efficacy and safety of endoscopic balloon sphinteroplasty(EBS), we attempted to remove common bile duct stones, less than 12 mm, without sphincterotomy in 11 patients. We also investigated the effects of sphincteroplasy on the motility of sphincter of Oddi before and after EBS. RESULTS: All patients were treated succesefully, with two patients administered sublingual nitroglycerine for the medical sphincter dilatation. Only one patient had mild abdominal pain, while the others experienced no complications. Follow-up manometric examinations showed the papillary function to be well preserved. CONCLUSION: This results suggested that the endoscopic balloon sphincteroplasy without sphincterotomy for the removal of small-sized stones is a useful and safe method, and its major advantage may lie in the preservation of the sphincter function. We recommend that prospective studies, preferably randomized, with clear objectives, are needed to clarify the success and safety of this technique compared to the standard sphincterotomy.
