Endoscopic Papillary Balloon Dilation in Cirrhotic Patients: Removal of Common Bile Duct Stones without Sphincterotomy

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Abstract
Background and Study Aims: Endoscopic papillary balloon dilation (EPBD) is a less invasive alternative to endoscopic sphincterotomy (EST). This study reviews a series of cirrhotic patients with bile duct stones who were treated with EPBD. Patients and Methods: EPBD was used to remove common bile duct stones in nine cirrhotic patients (one in Child-Pugh grade A, four in grade B, and four in grade C). After the papilla was dilated with balloon-tipped catheter, the stones were removed with a retrieval basket catheter or a retrieval balloon, or both. Mechanical lithotripsy was required in two patients with stones of more than 1 cm in diameter. Results: Clearance of the common bile duct was achieved in all patients without any serious complications such as hemorrhage or perforation. Conclusions: These results suggest that EPBD is a safe and effective technique for the treatment of common bile duct stones in patients with liver cirrhosis.

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