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Endoscopic Papillary Large Balloon Dilation Versus Endoscopic Sphincterotomy for Treatment of Bile Duct Stones

  • Endoscopy (P Siersema, Section Editor)
  • Published:
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Abstract

Purpose of review

To review the current literature focusing on the indications, efficacy, and safety of endoscopic papillary balloon dilation (EPBD) and endoscopic papillary large balloon dilation (EPLBD) with or without endoscopic sphincterotomy (EST) in the treatment of bile duct stones.

Summary/recent findings

• EPBD without EST is associated with a higher risk of post-procedural pancreatitis and lower rate of stone clearance than EST alone.

• EPBD without EST should be at least 2 min in duration, and placement of a pancreatic stent and other measures to reduce pancreatitis risk should be considered.

• EPBD without EST is most useful to reduce risk of bleeding in patients with coagulopathy.

• EPLBD combined with EST can be used as an alternative or adjunct to mechanical lithotripsy in the removal of large or difficult bile duct stones.

• EPLBD combined with EST results in fewer complications than EST alone for removal of bile duct stones.

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Abbreviations

CBD:

Common bile duct

ERCP:

Endoscopic retrograde cholangiopancreatography

EPBD:

Endoscopic papillary balloon dilation

EPLBD:

Endoscopic papillary large balloon dilation

EST:

Endoscopic sphincterotomy

EUS:

Endoscopic ultrasound

PAD:

Peri-ampullary diverticulum

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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  1. Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Minnesota, MMC 36, 420 Delaware St SE, Minneapolis, MN, 55455, USA

    Abdul Haseeb MD & Martin L. Freeman MD

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Haseeb, A., Freeman, M.L. Endoscopic Papillary Large Balloon Dilation Versus Endoscopic Sphincterotomy for Treatment of Bile Duct Stones. Curr Treat Options Gastro 17, 221–230 (2019). https://doi.org/10.1007/s11938-019-00234-5

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