Percutaneous transhepatic balloon dilation for papillary stenosis

In this study, a case of primary common bile duct stone due to papillary stenosis is reported. The patient was a 68-year-old man with complaints of epigastric pain and fever who had undergone gastrectomy at age 55 and cholecystectomy with choledocholithotomy at age 62. Laboratory data revealed elevation of the transaminases acid biliary enzymes. Both abdominal ultrasonography and CT scan revealed dilatation of the common bile duct with stones. Since endoscopic retrograde cholangiopancreatography could not visualize the bile duct, percutaneous transhepatic biliary drainage was carried out. After lithotripsy by percutaneous transhepatic cholangioscopy a diagnosis of papillary stenosis was made following percutaneous transhepatic manometry of the sphincter of Oddi, and balloon dilatation through the PTBD fistula was successfully performed. In this case report, emphasis is placed on the diagnosis and treatment of papillary stenosis.