title: Endoscopic papillary large-balloon dilation versus endoscopic papillary regular-balloon dilation for removal of large bile-duct stones.
abstract: BACKGROUND
  Endoscopic papillary large-balloon dilation (EPLBD) became popular for the treatment of large common bile-duct stones (CBDS), and its feasibility has been reported in comparison to endoscopic sphincterotomy. However, the comparison between EPLBD and endoscopic papillary regular-balloon dilation (EPBD) has not been reported. In the present study, the efficacy and complications of EPLBD were compared with those of EPBD.
  
  
  METHODS
  We retrospectively assessed 334 consecutive patients with CBDS of any size that were treated by either EPLBD or EPBD between January 2008 and December 2012.
  
  
  RESULTS
  In cases with large CBDS (>10 mm), EPLBD and EPBD had similar results in terms of the success rate of stone removal in the first (65% vs. 84%) and total attempts (100% vs. 95%), use of mechanical lithotripter (64% vs. 80%), and procedure time (48.0 ± 17.8 min vs. 44.1 ± 17.1 min). The necessity for crushing stones with a mechanical lithotripter was significantly decreased in EPLBD compared to EPBD (25% vs. 80%). In all cases with CBDS, there was no significant difference in complication rates between EPLBD and EPBD (3.3% vs. 4.7%).
  
  
  CONCLUSIONS
  Compared to EPBD, EPLBD appears safe and effective for removing large CBDS and decreases the necessity of lithotripsy.
authors.affiliation: Department of Gastroenterology, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa, Tokyo, 141-8625, Japan. toshio.fujisawa@east.ntt.co.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Fujisawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Kagawa
authors.forename: Kantaro
authors.initials: K
authors.lastname: Hisatomi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D015331:Cohort Studies; D004106:Dilatation / Q000295:instrumentation* / Q000379:methods; D016145:Endoscopy, Digestive System / Q000379:methods; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Complications; Endoscopic papillary balloon dilation; Endoscopic papillary large-balloon dilation; Large bile-duct stone; Mechanical lithotripter