Jin-Seok Park1, Seok Jeong, Jee Young Han, Don Haeng Lee. 1. Department of Internal Medicine, Digestive Disease Center, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon, 400-711, Republic of Korea.
Abstract
BACKGROUND/AIM: 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. PATIENTS AND 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). CONCLUSION: EBDL might be a safe and effective option for the treatment of large and impacted extrahepatic bile duct stones refractory to conventional endoscopic treatments.
BACKGROUND/AIM: 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. PATIENTS AND 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). CONCLUSION: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: Yu Ri Seo; Jong Ho Moon; Hyun Jong Choi; Dong Choon Kim; Ji Su Ha; Tae Hoon Lee; Sang-Woo Cha; Young Deok Cho; Sang-Heum Park; Sun-Joo Kim Journal: Dig Dis Sci Date: 2013-11-28 Impact factor: 3.199