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Material and Method: Between January 2003 and December 2009, the retrospective study of ninety-three patients with CBD stones that underwent endoscopic retrograde cholangiopancreaticography (ERCP) for stone removal and had difficulty were enrolled. ESPT using a large CRE™ Wireguided balloon dilatation was performed in 62 patients. The success rate of complete stone clearance and post ERCP complications were analyzed.
Results: In the aspect of complete stone removal, the success rate was 88.7%. Seven patients (11.3%) required adjunctive mechanical lithotripsy (ML) for complete stone clearance. This technique was associated with low complication rate (3.2%). Post ERCP bleeding was found in one patient (1.6%) with ESPT using a large CRE™ balloon dilatation. Mild post-ERCP pancreatitis occurred in only one patient.
Conclusion: ESPT using large diameter CRE™ Wireguided balloon dilatation after biliary sphinctertomy is an effective technique for a difficult CBD stone removal associated with a lower rate of complications. This procedure can avoid unnecessary surgical CBD exploration for stone removal.
Keywords: Endoscopic sphincteroplasty, Balloon dilatation, Mechanical lithotripsy, Common bile duct stone