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Rev Esp Enferm Dig. 2019 Feb 27;111. doi: 10.17235/reed.2019.5865/2018. [Epub ahead of print]

Endoscopic Papillary Large Balloon Dilatation (EPLBD) for the Extraction of Common Bile Duct Stones (CBDS).

Author information

1
Department of Internal Medicine, Faculty of Medicine, South Valley University, Qena, Egypt.
2
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
3
Department of Internal Medicine, Faculty of Medicine, Zagazig University, As-Sharquia, Egypt.
4
Department of Tropical Medicine and Gastroenterology, Al-Azhar University, Assiut, Egypt.
5
Department of Diagnostic Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
6
Department of Surgery, Faculty of Medicine, Zagazig University, As-Sharquia, Egypt..
7
Department off Internal Medicine, Faculty of Medicine, South Valley University, Egypt.
8
Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt..

Abstract

BACKGROUND AND AIM:

endoscopic papillary large balloon dilatation (EPLBD) is increasingly accepted as an appropriate option for the management of difficult common bile duct stones (CBDS). This study aimed to evaluate the safety and efficacy of EPLBD with a relatively large balloon (15-20 mm) for the extraction of difficult CBDS.

PATIENTS AND METHODS:

a total of 40 patients were recruited with obstructive jaundice and dilated CBD (≥ 10 mm) subsequent to a single large CBDS of ≥ 10 mm or multiple stones (≥ 3). All patients underwent endoscopic retrograde cholangio-pancreatography (ERCP) with limited sphincterotomy and large balloon dilatation followed by stone extraction using an extraction balloon or dormia basket, without lithotripsy, stenting or further ERCP sessions.

RESULTS:

successful stone extraction was achieved in 34 patients (85%) and stone extraction failure occurred in six patients (15%). Complications included minimal pancreatitis in four cases (10%), mild pancreatitis in two cases (5%), cholangitis in two cases (5%) and bleeding in two cases (5%). There were no recorded cases of perforation or mortality subsequent to the procedure.

CONCLUSION:

EPLBD is a safe and efficient procedure for the extraction of difficult CBDS and may be advisable in patients with a bleeding risk or abnormal papillary anatomy.

PMID:
30810329
DOI:
10.17235/reed.2019.5865/2018
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