Treatment of Choledocholithiasis Using Balloon Dilatation of the Papilla Via the Common Bile Duct

Tatsuhito Yamamoto, Katsuhiro Matoba, Yoshitaka Ikeda, Yoshitoshi Sato, Mutsuo Tsushimi, Seiichirou Andoh, Kureo Tsushimi

Department of Surgery, Tsushimi Hospital

Papillary dilatation using a balloon-tipped bilary catheter positioned across the papilla through the common bile duct, was performed for the treatment of 10 cases with bile duct stones. The balloon catheter was inserted into the common bile duct through the fistula of the percutaneous transhepatic biliary drainage in 4 cases, via the cystic duct during laparoscopic cholecystectomy in 5 cases, and through the fistula of the trans-cystic duct drainage tube after laparoscopic cholecystectomy in 1 case. Before the balloon dilatation of the papilla, precutaneous transhepatic cholangioscopy with pulsed dye laser lithotripsy was performed in 4 cases, in which the bile duct stones were over 10 mm in diameter. In 9 cases, balloon dilatation of the papilla was successful in removing the bile duct stones, but endoscopic sphincterotomy was required after the procedure to remove the residual stones completely in 1 case. After the procedure, the serum amylase level was elevated in 2 cases, but acute pancreatitis did not occur. Cholangitis was observed in 1 case. There has been no mortality to date. Recurrent stones were experi enced in only 1 case. This technique was useful to remove bile duct stones safely and easily.

Key words
choledocholithiasis, balloon dilatation of the papilla

Reprint requests
Tatsuhito Yamamoto Department of Surgery, Tsushimi Hospital
413-1 Emukai, Hagi, 758-0041 JAPAN

Accepted
September 16, 1998

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