Copyright ©2013 Baishideng Publishing Group Co.
World J Gastroenterol. Dec 14, 2013; 19(46): 8580-8594
Published online Dec 14, 2013. doi: 10.3748/wjg.v19.i46.8580
Table 10 Recommendations for successful endoscopic papillary large balloon dilation
1 EPLBD with large, especially full-incision EST should be avoided
2 EPLBD with limited EST is recommended to be performed, even before attempting trials of a standard technique with large EST, when the stone is seen to be too large on cholangiogram
3 EPLBD without EST may be useful in some patients with coagulopathy, periampullary diverticulum, or surgically altered anatomy
4 In patients with obvious distal bile duct strictures, EPBLD should be avoided. If there is a suspicion of strictures, using the pulling method of a large inflated retrieval balloon through the site is recommended to confirm an existence
5 The intended maximal target diameter of the balloon should be determined based on the diameter of the largest stones, but should not exceed the diameter of the distal bile duct
6 The balloon should always be inflated gradually, starting from a smaller diameter step of the balloon than the intended maximal target diameter
7 Further balloon inflation must be ceased, if the central waist of the balloon does not disappear or the patient indicates severe pain during balloon inflation at any step