Endoscopy 2018; 50(04): S191-S192
DOI: 10.1055/s-0038-1637627
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC PAPILLARY LARGE BALLOON DILATATION (EPLBD) FOR EXTRACTION OF COMMON BILE DUCT STONES. EARLY EXPERIENCE FROM QENA, EGYPT

M Alsenbesy
1   South Valley University (SVU), Internal Medicine, Qena, Egypt
,
M Tag-Aldeen Said
1   South Valley University (SVU), Internal Medicine, Qena, Egypt
,
M Abbas Sobh
2   Assiut University, Internal Medicine, Assiut, Egypt
,
H Elamien
3   Assiut University, Internal Medicine, Assiut, El Salvador
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Endoscopic papillary large balloon dilatation (EPLBD) is increasingly accepted as an appropriate option in management of difficult common bile duct (CBD) stones. Given the minor incision necessary, the short procedure time, the reduced requirement for mechanical lithotripsy (ML) and the low frequency of adverse events, EPLBD may be applied in patients who cannot tolerate wide endoscopic biliary sphincterotomy (EBS). The aim of our work was to evaluate the safety and efficacy of EPLBD with a relatively large balloon (15 – 20 mm) in extraction of difficult CBD stones.

Methods:

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

Results:

Successful stone extraction was achieved in 34 patients (85%), while failure of stone extraction occurred in 6 patients (15%). The noted complications were minimal pancreatitis in 4 cases (10%), mild pancreatitis in 2 cases (5%), cholangitis in 2 cases (5%) and bleeding in 2 cases (5%), while no recorded cases of perforation or mortality subsequent to our procedure.

Conclusions:

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