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

  • Abdul Haseeb
  • Martin L. FreemanEmail author
Endoscopy (P Siersema, Section Editor)

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.

Keywords

Biliary sphincterotomy Papillary balloon dilation Bile duct stones Choledocholithiasis 

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

Notes

Compliance with Ethical Standards

Conflict of Interest

Abdul Haseeb declares that he has no conflict of interest. Martin L. Freeman declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

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

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Authors and Affiliations

  1. 1.Division of Gastroenterology, Hepatology and Nutrition, Department of MedicineUniversity of MinnesotaMinneapolisUSA

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