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Post-sphincterotomy transampullary balloon dilation is a safe and effective technique
Thomas Kowalski1, Rahul A Nathwani, David Assis
1Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, 132 S 10th Street, Suite 480 Main Building, Philadelphia, PA 19107, USA.
Digestive Diseases and Sciences
|July 3, 2008
Summary
Ampullary balloon dilation (ABD) after endoscopic sphincterotomy (ES) is safe and effective for treating bile duct stones. This combined approach offers a successful alternative to ES alone, especially for large stones.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Biliary Tract Interventions
Background:
- Endoscopic sphincterotomy (ES) is a standard procedure for biliary interventions.
- Alternative or adjunct techniques are explored to improve outcomes, particularly for challenging cases like large common bile duct stones.
Purpose of the Study:
- To evaluate the safety and efficacy of performing ampullary balloon dilation (ABD) subsequent to endoscopic sphincterotomy (ES).
- To assess the utility of ABD as an adjunct to ES in managing biliary conditions.
Main Methods:
- Retrospective review of 69 patients undergoing ABD following ES between 2000 and 2007.
- Procedures utilized hydrostatic balloons (Hurricane RX or CRE esophageal dilating balloons).
Main Results:
- The combined ABD following ES approach was successful in 86% of cases.
- Indications included choledocholithiasis (58%), abnormal imaging (26%), and abnormal liver enzymes (23%).
- Complication rates were low: pancreatitis (2.9%), hemorrhage (1.5%), and perforation (1.5%).
Conclusions:
- Ampullary balloon dilation following endoscopic sphincterotomy is a safe and effective therapeutic option.
- This combined technique is particularly beneficial for the extraction of large common bile duct stones.
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