Korean J Pancreas Biliary Tract.  2019 Oct;24(4):175-181. 10.15279/kpba.2019.24.4.175.

Endoscopic Papillary Balloon Dilation/Endoscopic Papillary Large Balloon Dilation

• Jeong S

• KMID: 2464978
• DOI: http://doi.org/10.15279/kpba.2019.24.4.175

Abstract

Endoscopic papillary balloon dilation (EPBD) and endoscopic papillary large balloon dilation (EPLBD) have been performed all around the world over several decades for the treatment of common bile duct stone. EPBD using small dilation balloon catheter can preserve sphincter of Oddi function and reduce the recurrence rate of bile duct stone compared to endoscopic sphincterotomy (EST). EPBD is a procedure with low risk of bleeding, which is appropriate for patients with coagulopathy, hepatic cirrhosis, end-stage of renal disease, and surgically altered anatomy such as Billroth II gastrectomy and periampullary diverticulum. However, it has a higher risk of postprocedure pancreatitis than EST. EPLBD using large balloon catheter (12 mm or more of diameter) is proper for more than 10 mm of common bile duct stone. The advantages of EPLBD are reduced need for mechanical lithotripsy with decreased procedure time and radiation exposure time irrespective of the precedence of EST. EPLBD also requires fewer endoscopic retrograde cholangiopancreatography sessions and is more cost-effective. The incidence of post-procedure pancreatitis is lower in EPLBD than EST. If EPBD and EPLBD are done under the guidelines, these would be safe and effective and may be alternatives to EST for common bile duct stone.

Keyword

Choledocholithiasis; Endoscopic papillary balloon dilation; Endoscopic papillary large balloon dilation; Sphincterotomy; Endoscopic

MeSH Terms

Bile Ducts
Catheters
Cholangiopancreatography, Endoscopic Retrograde
Choledocholithiasis
Common Bile Duct
Diverticulum
Gastrectomy
Gastroenterostomy
Hemorrhage
Humans
Incidence
Lithotripsy
Liver Cirrhosis
Pancreatitis
Radiation Exposure
Recurrence
Sphincter of Oddi
Sphincterotomy, Endoscopic