Percutaneous papillary large balloon dilation during percutaneous cholangioscopic lithotripsy for the treatment of large bile-duct stones: a feasibility study.
When access to a major duodenal papilla or endoscopic retrograde cholangiopancreatography has failed, percutaneous transhepatic cholangioscopic lithotripsy (PTCS-L) may be useful for removing common bile duct (CBD) stones. However, the feasibility and usefulness of percutaneous transhepatic papillary large-balloon dilation (PPLBD) during PTCS-L for the removal of large CBD stones has not been established. We aimed to determine the safety and efficacy of PPLBD for the treatment of large CBD stones. Eleven patients with large CBD stones in whom the access to the major papilla or bile duct had failed were enrolled prospectively. Papillary dilation was performed using a large (12-20 mm) dilation balloon catheter via the percutaneous transhepatic route. Post-procedure adverse events and efficacy of the stone retrieval were measured. The initial success rate of PPLBD was 100%. No patient required a basket to remove a stone after PPLBD. Electrohydraulic lithotripsy was required in 2 (18.2%) patients. The median time to complete stone removal after PPLBD was 17.8 min and no adverse events occurred after PPLBD. Asymptomatic hyperamylasemia was not encountered in any patients. This study indicates that PPLBD is safe and effective for removal of large CBD stones.
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
Jee Young
0000-0002-5625-8444
JY
Han
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. ; National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Incheon, Korea.
Seok
0000-0001-6178-8338
S
Jeong
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. ; National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Incheon, Korea. ; Utah-Inha DDS & Advanced Therapeutics Research Center, Incheon, Korea.
Don Haeng
DH
Lee
D014670:Ampulla of Vater / Q000601:surgery; D001652:Bile Ducts / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000601:surgery*; D005240:Feasibility Studies; D042882:Gallstones / Q000601:surgery; D006801:Humans; D034321:Hyperamylasemia; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D016896:Treatment Outcome; D001744:Urinary Bladder Calculi / Q000601:surgery*
Ampulla of Vater; Balloon; Choledocholithiasis; Dilatation