Is balloon sweeping detrimental in portal biliopathy? A report of 3 cases.
BACKGROUND
Portal biliopathy is characterized by biliary obstruction and is commonly caused by dilated vascular channels in the pericholedochal plexus causing choledochal varices, leading to the formation of stones in the common bile duct. Endoscopic treatment leads to severe bleeding complications because of the rupture of these vascular channels.


OBJECTIVE
We report on our management of the unique bleeding complications we faced when performing endotherapy on these patients.


METHODS
A case series.


METHODS
Single-center experience in a tertiary care unit.


METHODS
Patients with portal hypertension and choledochal varices, presenting with symptoms of biliary obstruction caused by gallstones, were subjected to ERCP and stone removal by use of the balloon sweeping and basket extraction techniques.


CONCLUSIONS
Small volume case series; there is need for a randomized controlled study.


CONCLUSIONS
During stone removal, when compared to basket extraction, excessive bleeding was observed when balloon sweeping was used because this technique could cause squeezing of the choledochal varices.
Sharma
Malay
M
Department of Gastroenterology, Jaswantrai Speciality Hospital, Meerut, India.
Ponnusamy
Rajesh Prabhu
RP
D000328:Adult; D002404:Catheterization / Q000295:instrumentation*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D001651:Cholestasis, Extrahepatic / Q000150:complications* / Q000175:diagnosis; D003135:Common Bile Duct; D003937:Diagnosis, Differential; D005260:Female; D042882:Gallstones / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006504:Hepatic Veno-Occlusive Disease / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000175:diagnosis; D008297:Male