The ballooning time in endoscopic papillary balloon dilation for the treatment of bile duct stones

Byoung Wook Bang, Seok Jeong, Don Haeng Lee, Jung Il Lee, Jin-Woo Lee, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin, Young Soo Kim, Byoung Wook Bang, Seok Jeong, Don Haeng Lee, Jung Il Lee, Jin-Woo Lee, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin, Young Soo Kim

Abstract

Background/aims: Endoscopic papillary balloon dilation (EPBD) is a safe and effective method for the treatment of choledocholithiasis, but previous studies have rarely reported the appropriate ballooning time (BT). We prospectively evaluated the safety and efficacy of EPBD according to BT in patients undergoing bile duct stone removal.

Methods: Seventy consecutive patients with bile duct stones were randomly assigned to receive EPBD with either conventional (n = 35, 60 seconds) or short (n = 35, 20 seconds) BT.

Results: EPBD alone achieved complete bile duct clearance in 67 patients (long BT, n = 33, 94.3%; short BT, n = 34, 97.1%; p = 0.808). We also found no significant difference in the rate of complete duct clearance, including procedures that used mechanical lithotripsy, between the long and short BT groups (97.1% vs. 100%; p = 0.811). Mild pancreatitis was noted in four (11.4%) patients in the long BT group and two (5.7%) patients in the short BT group, but this incidence was not significantly different.

Conclusions: The study showed that EPBD using both 20-sec and 60-sec BTs is safe and effective for the treatment of bile duct stones. Short and long BTs produced comparable outcomes.

Keywords: Choledocholithiasis; Endoscopic papillary balloon dilation; Pancreatitis.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Cholangiogram showing endoscopic papillary balloon dilation. (A) The biliary sphincter is visible as a 'waist' during balloon inflation. (B) The biliary sphincter is adequately dilated when the balloon's waist has completely disappeared.

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