title: New large-diameter balloon-equipped sphincterotome for removal of large bile duct stones (with videos).
abstract: 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.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan. itoi@tokyo-med.ac.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sofuni
authors.forename: Fumihide
authors.initials: F
authors.lastname: Itokawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Kurihara
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ishii
authors.forename: Shujiro
authors.initials: S
authors.lastname: Tsuji
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Ikeuchi
authors.forename: Junko
authors.initials: J
authors.lastname: Umeda
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
mesh_terms: 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
chemical_list: D005020:Ethyl Methanesulfonate; C093407:ethyl ethanesulfonate