title: Safety and efficacy of large balloon sphincteroplasty in a third care hospital.
abstract: OBJECTIVE
  large balloon sphincteroplasty (LBS) associated with sphincterotomy (ES) has gained acceptance as a useful tool in extracting difficult bile duct stones. Our purpose was to evaluate the efficacy and safety of LBS with balloons > or = 10 mm in clinical practice setting.
  
  
  METHODS
  unicentre prospective study in a tertiary care hospital. All patients who underwent LBS associated with ES between July 2007 and March 2011 were included prospectively in a database recording clinical aspects, procedure data, outcome and complications.Success is the main outcome defined as complete stone removal documented by absence of any filling defect during a final occlusion cholangiogram and absence of clinical or radiological findings after the ERCP consistent with remaining stones. Complications as pancreatitis, cholangitis, post-ERCP bleeding, perforation and others were also measured.
  
  
  RESULTS
  one hundred twenty procedures were made in 109 patients with balloons ranging from 10 to 20 mm. Success rate was 91% in the first attempt and 96.7% after two procedures. Mechanical lithotripsy was only needed in one case (0.8%). Complication rate was 4.2% due to five cases of post-ERCP bleeding in high risk patients.
  
  
  CONCLUSIONS
  large balloon sphincteroplasty associated to sphincterotomy in clinical practice is a very effective and safe technique.
authors: Department of Digestive Diseases, Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid, Spain. emartina.hulp@salud.madrid.org
authors: Eduardo
authors: E
authors: Martín-Arranz
authors: Rafael
authors: R
authors: Rey-Sanz
authors: María Dolores
authors: MD
authors: Martín-Arranz
authors: Francisco
authors: F
authors: Gea-Rodríguez
authors: Pedro
authors: P
authors: Mora-Sanz
authors: José María
authors: JM
authors: Segura-Cabral
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057785:Catheters; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000601:surgery*; D004106:Dilatation / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016717:Sphincterotomy, Endoscopic / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome