A new technique for removal of bile duct stones with an expandable metallic stent.
BACKGROUND
Endoscopic sphincterotomy is used routinely for extraction of bile duct stones. Also, endoscopic papillary dilation is a safe and effective technique that significantly reduces the need for papillotomy. However, extraction of large and/or multiple stones after endoscopic papillary dilation can be difficult. A new technique, endoscopic metallic stent-lithotripsy, for treatment of bile duct stones without endoscopic sphincterotomy or endoscopic papillary dilation is described.


METHODS
A self-expandable metallic stent was used to dilate the major duodenal papilla to allow lithotripsy and removal of bile duct stones in 38 patients.


RESULTS
The bile duct was successfully cleared of stones in 36 cases (95%). Complications included one episode of mild pancreatitis and one of cholangitis.


CONCLUSIONS
Although the number of patients who underwent successful expanding metallic stent-lithotripsy was small, the method is promising as an alternative to endoscopic sphincterotomy and endoscopic papillary dilation.
Minami
Atsushi
A
Nihon Medical School 2nd Hospital, Gastroenterological Center, Kawasaki Kyodo Hospital, Nakahara-Ku, Kawasaki City, Kanagawa Prefecture, Japan.
Fujita
Rikiya
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000628:therapy; D002758:Cholangiography; D002769:Cholelithiasis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents / Q000009:adverse effects