Endoscopic Sphincterotomy Combined with Large Balloon Dilation for Removal of Large Bile Duct Stones

Abstract

An endoscopic treatment using EST plus large balloon dilation against large or multiple bile duct stones was suggested to be safe and effective.

Old age is associated with increased severity of complications in endoscopic biliary stone removal

“…[1][2][3][4] Various techniques, such as biliary cannulation, sphincterotomy, lithotripsy, and stone fragment extraction, are required particularly during endoscopic biliary stone removal. For patients with difficult stones who have undergone surgery or transhepatic techniques in the past, useful endoscopic techniques, such as endoscopic sphincterotomy combined with large balloon dilation (ESLBD) [5][6][7] or electrohydraulic shock-wave lithotripsy (EHL) under peroral cholangioscopy, 8 have been developed. Moreover, singleballoon endoscopy 9 or double-balloon endoscopy (DBE) 10 can be used in patients with postoperative altered gastrointestinal anatomy.…”

Tips in biliary stone removal using endoscopic papillary large balloon dilation

“…The duration of dilation required during ESLBD also varies among different endoscopists and the reported duration ranges from 0 to 2 min . The use of 30 s dilation has been compared to 60 s in a randomized trial, but no difference in the rates of complete stone removal and adverse events were detected .…”

Endoscopic Papillary Large Balloon Dilation: Guidelines for Pursuing Zero Mortality

“…Nevertheless, this does not mean that EPLBD is completely safe in patients with dilated CBD, considering the lack of large-scale multicenter clinical studies and possible reluctance of clinicians to report serious AEs. The outcomes and AEs of EPLBD are summarized in Tables 1, 2 1,3-19…”