Small sphincterotomy combined with papillary dilation with large balloon permits retrieval of large stones without mechanical lithotripsy

Figure 1 Large and multiple stones were confirmed by endoscopic retro-grade cholangiopancreatography.

Figure 2 Large balloon dilation was performed (max 20 mm in a diameter) after small ES.

Figure 3 CBD stones could be removed by basket from the bile duct through the large orifice without lithotripsy.