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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2016

Open Access 01-12-2016 | Research article

Limited precut sphincterotomy combined with endoscopic papillary balloon dilation for common bile duct stone removal in patients with difficult biliary cannulation

Authors: Chung-Mou Kuo, Yi-Chun Chiu, Chih-Ming Liang, Lung-Sheng Lu, Wei-Chen Tai, Yuan-Hung Kuo, Cheng-Kun Wu, Seng-Kee Chuah, Chi-Sin Changchien, Chung-Huang Kuo

Published in: BMC Gastroenterology | Issue 1/2016

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Abstract

Background

Difficult biliary cannulation in endoscopic retrograde cholangiopancreatography (ERCP) can result in failure of common bile duct (CBD) stone removal and pancreatitis. The present study aimed to report the efficacy and safety of limited precut sphincterotomy (PS) combined with endoscopic papillary balloon dilation (EPBD) for CBD stone removal in patients with difficult biliary cannulation, and the complications associated with this combined procedure.

Methods

A total of 3305 patients underwent ERCP in our hospital between October 2009 and September 2014 and 258 were diagnosed with difficult biliary cannulation. Of these 258 patients, 58 underwent limited PS combined with EPBD for CBD stone removal, and these 58 patients were included in this retrospective study.

Results

The overall success rate was 94.8 % (55/58), and the success rate for single-session removal was 87.9 % (51/58). The mean procedure time was 41 ± 11.48 min (range, 20–72 min). Mechanical lithotripsy was needed in 10.3 % (6/58) of patients. Procedure-related complications included bleeding in 3.4 % (2/58), pancreatitis in 8.6 % (5/58) and biliary tract infection (BTI) in 1.7 % (1/58) of patients.

Conclusions

The therapeutic outcome of limited PS combined with EPBD for CBD stone removal in patients with difficult biliary cannulation was good with an acceptable complication rate. It could be an alternative to PS and “early” limited PS should be used for prompt identification of the bile duct. Limited PS combined with EPBD is safe and effective for CBD stone removal in patients with difficult biliary cannulation.
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Metadata
Title
Limited precut sphincterotomy combined with endoscopic papillary balloon dilation for common bile duct stone removal in patients with difficult biliary cannulation
Authors
Chung-Mou Kuo
Yi-Chun Chiu
Chih-Ming Liang
Lung-Sheng Lu
Wei-Chen Tai
Yuan-Hung Kuo
Cheng-Kun Wu
Seng-Kee Chuah
Chi-Sin Changchien
Chung-Huang Kuo
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2016
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-016-0486-4

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