The large-balloon occupation technique: a new technique for removing multiple biliary stones from a large-diameter bile duct

Yamauchi, Hiroshi; Kida, Mitsuhiro; Uehara, Kazuho; Miyata, Eiji; Okuwaki, Kosuke; Inoue, Hiroshi; Koizumi, Wasaburo

doi:10.1055/s-0043-106733

Cited by 2 publications

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“…No perforation was observed in patients dilated from 12 to 15 mm [16] and in our technique, we never dilate >15 mm. The presence of a stone could increase the risk of perforation, but this was not observed in our study as well as in the one by Park et al [9] and 2 other case reports [7, 8]. We presume that harder stones, especially some cholesterol stones originated in the gallbladder, pose an extra perforation risk due to the fact that in large balloon lithotripsy, the stone is pressed against the bile duct wall and the wall in contact with the balloon or the stone may rupture.…”

Section: Discussioncontrasting

confidence: 72%

Endoscopic Biliary Large Balloon Dilation Lithotripsy for Giant and Impacted Stones Removal: A Western Series

Lima

Sanmartin

Onófrio

et al. 2020

Dig Dis

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Background: Endoscopic removal of packed, large, or impacted stones, in which a basket cannot be deployed or is unable to grasp the stone(s), is challenging and inevitably leads to repeated procedures such as stent insertion and extra- or intracorporal lithotripsy. In this study, we describe the results of an alternative stone disintegration technique in a considerable series of patients using an esophageal/pyloric balloon for stone fragmentation or making working space in the bile duct to allow the deployment of the basket, a technique we call endoscopic biliary large balloon lithotripsy. Methods: We retrieved data from 1,429 endoscopic retrograde cholangiopancreatographies (ERCPs) from 2 prospective trials performed between 2014 and 2019. Patients with difficult bile duct stones, in which a balloon dilator up to 15 mm was used to crush or increase the working space parallel to the stones in the common or hepatic duct, were included in the study. Results: From the 1,429 ERCPs, 299 had difficult stones (>1 cm, impacted or multiple stones). Large balloon lithotripsy was employed in 46 cases after endoscopic papillotomy and endoscopic biliary large balloon dilation with failed attempted balloon or basket stone(s) extraction. Failure to clear the bile duct at first ERCP occurred in 4 cases (91.3% of success). Complications were observed in 5 patients (10.8%; 1 perforation, 1 pancreatitis, and 3 bleedings), who were treated conservatively. Conclusions: Large balloon lithotripsy, in order to crush the stones or make working room for baskets or balloons in the bile duct, is an effective, safe, and low cost technique for impacted, packed, or giant bile duct stones.

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Section: Discussioncontrasting

confidence: 72%

Endoscopic Biliary Large Balloon Dilation Lithotripsy for Giant and Impacted Stones Removal: A Western Series

Lima

Sanmartin

Onófrio

et al. 2020

Dig Dis

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“…We previously designed and reported the large-balloon occupation technique designed for patients with many bile-duct stones that are difficult to remove. [1] The new technique is based on this procedure. A balloon catheter is inserted into the bile duct upstream to the site of malignant biliary obstruction to induce occlusion.…”

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confidence: 99%

The large-balloon occlusion technique: A new method for conversion to EUS-guided hepaticogastrostomy in patient with prior self-expanding metal stent placement

et al. 2019

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The large-balloon occupation technique: a new technique for removing multiple biliary stones from a large-diameter bile duct

Abstract: Reference[1] Yasuda I, Itoi T. Recent advances in endoscopic management of difficult bile duct stones.

Cited by 2 publications

References 1 publication

Endoscopic Biliary Large Balloon Dilation Lithotripsy for Giant and Impacted Stones Removal: A Western Series

Endoscopic Biliary Large Balloon Dilation Lithotripsy for Giant and Impacted Stones Removal: A Western Series

The large-balloon occlusion technique: A new method for conversion to EUS-guided hepaticogastrostomy in patient with prior self-expanding metal stent placement

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