Original Article
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World J Gastrointest Endosc. May 16, 2013; 5(5): 211-218
Published online May 16, 2013. doi: 10.4253/wjge.v5.i5.211
Endoscopic papillary balloon dilation after sphincterotomy for difficult choledocholithiasis: A case-controlled study
Bruno Rosa, Pedro Moutinho Ribeiro, Ana Rebelo, António Pinto Correia, José Cotter
Bruno Rosa, Pedro Moutinho Ribeiro, Ana Rebelo, António Pinto Correia, José Cotter, Department of Gastroenterology, Alto Ave Hospital Center, 4835-044 Guimarães, Portugal
Author contributions: Rosa B carried out the studies and data analyses, and drafted the manuscript; Moutinho Ribeiro P conceived the study, participated in its design and coordination, and helped to draft the manuscript; Rebelo A performed the statistical analysis; Pinto Correia A collaborated in the study conception and design; Cotter J critically revised the manuscript and finally approved the version to be submitted; all authors read and approved the final manuscript.
Correspondence to: Bruno Rosa, MD, Department of Gastroenterology, Alto Ave Hospital Center, Guimarães Rua dos Cutileiros, 4835-044 Guimarães, Portugal. bruno.joel.rosa@gmail.com
Telephone: +351-25-3540330 Fax: +351-25-3421308
Received: November 12, 2012
Revised: January 31, 2013
Accepted: February 5, 2013
Published online: May 16, 2013
Core Tip

Core tip: The technique described by Ersoz comprises endoscopic limited sphincterotomy followed by papillary large balloon dilation. In theory, it increases efficacy on the extraction of large bile duct stones, while reducing the risk of bleeding that would occur if a larger sphincterotomy had to be performed, particularly in patients with coagulopathy or surgically modified anatomy, and simultaneously reduces the risk of post endoscopic retrograde cholangio-pancreatography acute pancreatitis that occurs when isolated papillary balloon dilation is performed. In this case-controlled study, the combined technique achieved higher rate of complete stone clearance than isolated endoscopic sphincterotomy, and reduced the need for lithotripsy and biliary stenting, with a similar safety profile.