Balloon sphincteroplasty and transpapillary elimination of bile duct stones: 10 years' experience.

OBJECTIVE: The usual way for interventional radiology to treat stones in the bile duct involves their extraction with Dormia baskets. The technique of dilating the sphincter with a balloon and the transpapillary elimination of the stones has only sporadically been reported in the literature. In this article, we describe our experience with this technique.
MATERIALS AND METHODS: Between 1992 and 2001, we used this technique on 100 patients between the ages of 17 and 93 years (mean age, 68 years). The minimum diameter of the stones varied between 4 and 22 mm (mean size, 11 mm), and in 46 patients, only a single stone was seen. The stones were located in the common bile duct, and in 11 patients, intrahepatic stones were also observed. The approach was performed through a percutaneous biliary drainage tract in 48 patients, following the surgical tract of the Kehr tube in 36 patients, through a surgical transcystic drainage catheter in 10 patients, and through a percutaneous cholecystostomy in six patients.
RESULTS: The procedure was successful in 95% of the patients. The morbidity rate was 5%, and the procedure did not produce mortality in any of the cases. Eighty-nine patients required one session, 10 patients required two sessions, and the remaining patient required five sessions. The mean period of hospitalization after the procedure was 5.5 days (range, 1-40 days).
CONCLUSION: Balloon sphincteroplasty and transpapillary elimination of bile duct stones is an effective and safe technique.