Balloon catheter sphincteroplasty and biliary stone expulsion into the duodenum in patients with an indwelling T tube

Background: To present an alternate approach for treating residual biliary stones in patients with indwelling T tube that uses the immature tract crea ted by the T tube to carry out both sphincteroplasty and expulsion of the c alculi with the same angioplasty balloon catheter. Methods: This technique was performed in five patients. Access to the bile duct was through an 8-Fr T tube. First a guidewire was inserted and advance d beyond the obstructing stone to the duodenal lumen. The T tube was remove d over the guidewire, and a balloon catheter was introduced. Sphincteroplas ty was carried out. Then the balloon was deflated and retracted to a positi on proximal to the stone. It was then reinflated and used to push the stone , expelling it into the duodenum. Results: In all cases, all biliary stones were expelled without pain, in a single session, and with no immediate complications. All patients showed ra pid clinical and analytic improvement. During clinical and echographic foll ow-up of 2-22 months (mean = 12.4 months), there were no complications or r elapses. Conclusions: Our limited experience indicates that sphincteroplasty and exp ulsion of biliary stones with angioplasty balloon catheters through the T t ube immature tract is a simple, safe, low-cost technique that gives good re sults.