Endoscopic Sphincterotomy Plus Endoscopic Papillary Large Balloon Dilatation for Large Bile Duct Stones.
- Author:
Seoung Joon HWANG
1
;
Young Gyun KIM
;
Kyu Chul LEE
;
Myung Kwan JI
;
Hyun Soo KIM
;
Soon Goo BAIK
;
Kuen Man LEE
;
Jin Hyuck CHANG
;
Min Su KIM
;
Yong Han PAIK
;
Se Joon LEE
;
Hyo Jin PARK
;
Kwan Sik LEE
;
Sang In LEE
;
Dong Ki LEE
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. dklee@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Choledocholithiasis;
Endoscopic sphincterotomy;
Endoscopic papillary balloon dilatation
- MeSH:
Amylases;
Bile Ducts*;
Bile*;
Choledocholithiasis;
Common Bile Duct;
Dilatation*;
Diverticulum;
Epinephrine;
Hemorrhage;
Humans;
Inflation, Economic;
Lipase;
Mortality;
Pancreatitis;
Sphincterotomy, Endoscopic*
- From:Korean Journal of Gastrointestinal Endoscopy
2006;32(3):184-189
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The extraction of large common bile duct (CBD) stones after an endoscopic sphincterotomy (EST) is successful in 80~90% of cases but it often requires a prolonged time and repeated trials. This study investigated the utility of a combined endoscopic papillary large balloon dilatation (EPLBD) and a mid-incision of an EST (m-EST) method for the removal of large CBD stones. METHODS: Thirty patients with large CBD stones were enrolled in this study. EPLBD was carried out using the one-step inflation of a 15~18 mm diameter balloon after m-EST. RESULTS: The maximum stone diameter was 21.62+/-5.38 mm. Twelve patients had more than 4 stones, 7 patients had 2 stones, and the remainder had a single large stone. Complete ductal clearance was achieved in all patients. After the procedure, the serum amylase and/or lipase levels were elevated in 3 patients (13.3%). However, there was no episode of true pancreatitis. Minor bleeding was encountered in only one patient (3.3%), and was easily controlled by an endoscopic epinephrine injection. The procedure was carried out safely in 6 patients with periampullary diverticulum. No perforation or mortality was encountered. CONCLUSIONS: Combined EPLBD and m-EST is a safe and effective method, and may be a good alternative treatment for removing large CBD stones.
