New large-diameter balloon-equipped sphincterotome for removal of large bile duct stones (with videos).
BACKGROUND
Recently, endoscopic biliary sphincterotomy (EBS) followed by large-diameter balloon dilation has been used for the removal of large bile duct stones. A limitation is the need for 2 accessories: a sphincterotome and a dilating balloon.


OBJECTIVE
To evaluate a new device, a combination of a large-diameter dilating balloon and sphincterotome (LDDBS).


METHODS
Retrospective study.


METHODS
University hospital.


METHODS
Eighteen patients with large bile duct stones.


METHODS
After performing EBS by using the LDDBS, the catheter was then advanced into the bile duct and balloon dilation was performed by gradual inflation with diluted contrast medium under endoscopic and fluoroscopic guidance until it reached a diameter adequate to allow stone removal.


METHODS
Feasibility and efficacy of stone removal by using an LDDBS.


RESULTS
Technical success of large-diameter balloon dilation after EBS was achieved in all cases. Bile duct clearance was accomplished in 94% (17/18) of cases in the first session. Bile duct clearance was eventually completed in all patients. Mechanical lithotripsy was required in 4 patients (22%). There were no major intraprocedural or postprocedural complications.


CONCLUSIONS
Single-institution study, small sample size.


CONCLUSIONS
The prototype LDDBS is safe and effective to facilitate the removal of large bile duct stones by using one accessory.
Itoi
Takao
T
Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan. itoi@tokyo-med.ac.jp
Sofuni
Atsushi
A
Itokawa
Fumihide
F
Kurihara
Toshio
T
Tsuchiya
Takayoshi
T
Ishii
Kentaro
K
Tsuji
Shujiro
S
Ikeuchi
Nobuhito
N
Umeda
Junko
J
Moriyasu
Fuminori
F
D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005020:Ethyl Methanesulfonate / Q000031:analogs & derivatives; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000295:instrumentation* / Q000379:methods
D005020:Ethyl Methanesulfonate; C093407:ethyl ethanesulfonate