title: Endoscopic balloon dilation lithotripsy for difficult bile duct stones.
abstract: OBJECTIVE
  Endoscopic treatment for removal of large or impacted bile duct stones is challenging, and may not be successful. The aim of this study was to evaluate the safety and efficacy of endoscopic balloon dilation lithotripsy (EBDL) as a means of treating difficult extrahepatic bile duct stones refractory to failed conventional endoscopic treatments.
  
  
  METHODS
  The patients were included in the indication of EBDL only if stones were confirmed as brown-pigmented stones or recurrent. Balloon dilation was performed using a balloon dilation catheter in order to crush large and/or impacted stones at the common hepatic duct or common bile duct level in seven cases, and then fragmented stones were removed using a basket and/or an extraction balloon catheter.
  
  
  RESULTS
  The median diameter of the balloons used for EBDL was 32.4 ± 10.5 mm (range, 12.4-52.1). Balloon dilation was performed for 60 s per session. The mean number of EBDL sessions required to crush stones was two (range, 1-5), the mean number of ERCP sessions required for complete stone removal was 2.4 ± 0.8 (range, 1-3), the overall procedure-related complication rate was 0% (0/7), and the success rate was 100% (7/7).
  
  
  CONCLUSIONS
  EBDL might be a safe and effective option for the treatment of large and impacted extrahepatic bile duct stones refractory to conventional endoscopic treatments.
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon, 400-711, Republic of Korea.
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Park
authors.forename: Seok
authors.initials: S
authors.lastname: Jeong
authors.forename: Jee Young
authors.initials: JY
authors.lastname: Han
authors.forename: Don Haeng
authors.initials: DH
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
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