Endoscopic Papillary Large Balloon Dilation Combined with Guidewire-Assisted Precut Papillotomy for the Treatment of Choledocholithiasis in Patients with Billroth II Gastrectomy
Gut and Liver
;
: 200-203, 2011.
Article
in English
| WPRIM
| ID: wpr-118226
ABSTRACT
BACKGROUND/AIMS:
Endoscopic extraction of bile duct stones is difficult and often complicated in patients with a Billroth II gastrectomy. We evaluated a simpler technique to achieve an adequate ampullary opening for the removal of choledocholithiasis using endoscopic papillary large balloon dilation (EPLBD) combined with a guidewire-assisted needle-knife papillotomy.METHODS:
Sixteen patients who had a Billroth II gastrectomy were included in this study. Following placement of the guidewire in the bile duct, a precut incision was made over the guidewire with a needle knife sphincterotome inserted alongside the guidewire. Balloon dilation of the ampullary orifice was gradually performed.RESULTS:
Needle knife papillotomy over the guidewire with subsequent EPLBD was successful in all patients. Complete stone removal was achieved in 15 (93.7%) patients in 1 session. However, 1 (6.3%) patient required mechanical lithotripsy with an additional procedure for complete ductal clearance, and there was 1 case of minor bleeding following the EPLBD. There were no cases of pancreatitis or perforation.CONCLUSIONS:
EPLBD followed by guidewire-assisted needle-knife papillotomy appears to be a useful method with few technical difficulties and a low risk of complications for the removal of bile duct stones in patients with prior Billroth II gastrectomy.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pancreatitis
/
Bile Ducts
/
Lithotripsy
/
Gastroenterostomy
/
Choledocholithiasis
/
Gastrectomy
/
Hemorrhage
/
Needles
Limits:
Humans
Language:
English
Journal:
Gut and Liver
Year:
2011
Type:
Article
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