Repeat sphincterotomy: does its safety depend on the interval from the initial procedure?

Can a small endoscopic sphincterotomy plus a large-balloon dilation reduce the use of mechanical lithotripsy in patients with large bile duct stones?

“…In general, EST can be performed safely up to the ductduodenal junction. The endoscopic landmark of EST can be deformed or made unremarkable by concomitant PAD or previous endoscopic biliary sphincterotomy, leading to perforation [15,16]. Papillary balloon dilation at this junction dilates the distal CBD and the papillary opening together in one direction, thereby minimizing the potential for perforation.…”