[Large balloon dilation for removal of bile duct stones].
OBJECTIVE
To assess the efficacy and safety of dilatation of the papilla of Vater with large balloons for the treatment of choledocolithiasis in patients with difficult or risky extraction due to stone characteristics or peripapillary anatomy.


METHODS
Prospective.


METHODS
This study includes 93 patients in whom large-balloon dilation was performed between June 2005 and January 2008. Patients had multiple large stones, tapered distal CBD (common bile duct), peri-/intra-diverticular papilla, and previous sphincterotomy or Billroth-II surgery. A controlled radial expansion (CRE) balloon with a diameter range of 12-20 mm was used.


RESULTS
Stone removal was achieved in a single session in all patients (100 %). Most procedures (86%) did not require an extended exploration time. Mechanical lithotripsy was needed in 3.2 % of cases. There were two mild complications (2.1%). Hyperamilasemia was detected in 16% of patients.


CONCLUSIONS
Papillary dilation with a large balloon is an effective, safe, and easy technique for the retrieval of difficult common bile-duct stones. The procedure neither adds time to the exploration, nor increases complications, and obviates the need for mechanical lithotripsy in a majority of patients.
Espinel
J
J
Servicios de Aparato Digestivo, Hospital de León. jespinel@telefonica.net
Pinedo
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D002404:Catheterization; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome