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Related Experiment Videos

Endoscopic papillary balloon dilation after sphincterotomy for difficult choledocholithiasis: A case-controlled

Bruno Rosa1, Pedro Moutinho Ribeiro, Ana Rebelo

  • 1Bruno Rosa, Pedro Moutinho Ribeiro, Ana Rebelo, António Pinto Correia, José Cotter, Department of Gastroenterology, Alto Ave Hospital Center, 4835-044 Guimarães, Portugal.

World Journal of Gastrointestinal Endoscopy
|May 17, 2013
PubMed
Summary

Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...

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Endoscopic papillary large balloon dilation (EPLBD) combined with endoscopic sphincterotomy (EST) offers a safe and effective treatment for difficult bile duct stones (BDS). This approach significantly improves stone clearance rates and reduces the need for additional procedures like lithotripsy and biliary stenting.

Area of Science:

  • Gastroenterology
  • Endoscopic procedures
  • Biliary stone management

Background:

  • Bile duct stones (BDS) pose a significant clinical challenge, often requiring multiple endoscopic retrograde cholangio-pancreatography (ERCP) sessions.
  • Large or multiple BDS can complicate standard endoscopic sphincterotomy (EST) procedures.

Purpose of the Study:

  • To compare the efficacy and safety of EST combined with endoscopic papillary large balloon dilation (EPLBD) against isolated EST for treating large bile duct stones.
  • To evaluate the impact of EPLBD on stone clearance rates, procedural sessions, and the need for auxiliary treatments.

Main Methods:

  • A retrospective study included 111 patients with large (≥ 10 mm) BDS undergoing ERCP.
  • Group A received EST followed by EPLBD (12-18 mm balloons), while Group B underwent isolated EST.
Keywords:
Bile duct stonesCholedocholithiasisEndoscopic papillary large balloon dilationEndoscopic sphincterotomy

Related Experiment Videos

  • Outcomes assessed included complete stone clearance, number of sessions, need for mechanical/extracorporeal lithotripsy, biliary stenting, and complication rates.

    • Main Results:

    • Complete stone clearance was significantly higher in the EST+EPLBD group (95.6%) compared to the isolated EST group (69.8%) (P < 0.001).
    • The EST+EPLBD group required fewer therapeutic sessions (1.1 vs 1.8, P < 0.001) and less mechanical lithotripsy (14.7% vs 37.2%, P = 0.007).
    • Fewer patients in the EST+EPLBD group needed biliary stenting (17.6% vs 60.5%, P < 0.001), with similar complication rates between groups.

    Conclusions:

    • EST+EPLBD is a safe and highly effective technique for managing difficult bile duct stones.
    • This combined approach enhances stone clearance and reduces the necessity for repeat procedures and interventions like lithotripsy and stenting.