title: Is balloon sweeping detrimental in portal biliopathy? A report of 3 cases.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Jaswantrai Speciality Hospital, Meerut, India.
authors.forename: Malay
authors.initials: M
authors.lastname: Sharma
authors.forename: Rajesh Prabhu
authors.initials: RP
authors.lastname: Ponnusamy
mesh_terms: 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