Endoscopic papillary dilation by balloon and isosorbide dinitrate drip infusion for removing bile duct stone.
BACKGROUND
Endoscopic papillary dilation (EPD) by balloon in the management of bile duct stones has recently been claimed to be effective for removing bile duct stones.


METHODS
Without endoscopic sphincterotomy, we attempted to remove large or multiple bile duct stones through EPD combined with drip infusion of isosorbide dinitrate in 35 patients. Isosorbide dinitrate, at a rate of 5 mg/h, was administered intravenously, and a balloon dilator with a 10-mm diameter was inflated within 3 min across the papilla. Stones were then smashed using a mechanical lithotriptor, and the fragments were extracted with a basket or the balloon.


RESULTS
Extraction of stones was successful in 33 (94%) of 35 patients by the combined therapy. Two of them (6%) developed mild pancreatitis.


CONCLUSIONS
EPD combined with medical sphincter dilation was effective for large and multiple bile duct stones.
Third Dept. of Internal Medicine, Kagawa Medical University, Japan.
A
A
Minami
T
T
Maeta
F
F
Kohi
T
T
Nakatsu
S A
SA
Morshed
M
M
Nishioka
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D007548:Isosorbide Dinitrate / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate