Percutaneous papillary balloon dilatation as a therapeutic option for cholecystocholedocholithiasis in the era of laparoscopic cholecystectomy

The present study was conducted to evaluate the effectiveness of percutaneo us papillary balloon dilatation (PPBD) as a therapeutic option for cholecys tocholedocholithiasis, in combination with laparoscopic cholecystectomy (LC ). A total of 15 patients with both bile duct and gallbladder stones were c linically investigated. In 14 patients, PPBD was performed 2 to 7 days prio r to LC, while in the remaining patient, PPBD was performed immediately aft er LC under general anesthesia in one continuous session. The bile duct sto nes were successfully pushed out into the duodenum in all the patients, sev en of whom required two sessions for complete stone clearance, while the ot her eight needed only one session. Two patients had bile duct stones larger than 12 mm in diameter, necessitating electrohydraulic lithotripsy under c holangioscopy. The insertion of a percutaneous transhepatic biliary drainag e tube did not cause intra-abdominal adhesions severe enough to contraindic ate the use of LC. The operation times for LC varied from 80 to 184 min, wi th a mean operation time of 132 min, and the average postoperative and over all hospital stays were 9 and 26 days, respectively. There were no deaths o r major complications, apart from transient hyperamylasemia, The findings o f this study indicate that PPBD combined with LC is a safe and effective th erapeutic option for cholecystocholedocholithiasis.