THE ROLE OF ENDOSCOPIC BALLOON SPHINCTEROPLASTY IN PATIENTS WITH GALLBLADDER AND BILE-DUCT STONES

We clarified the significance of endoscopic balloon sphincteroplasty ( EBS) in the therapeutic treatment of biliary tract stones in the prese nt era of laparoscopic cholecystectomy (LC). Patients with cholecysto- choledocholithiasis (n = 33) were treated by EBS. After endoscopic ret rograde cholangiography (ERC), a balloon catheter (8 mm in diameter an d 3 cm in width) was inserted into the bile duct using a guidewire, an d positioned at the sphincter of Oddi. After inflating the balloon cat heter, bile duct stones were removed by mechanical lithotripsy, a bask et catheter, or a balloon catheter. In all patients, bile duct stones were removed by EBS without endoscopic sphincterotomy. No complication occurred except for 2 cases of mild pancreatitis, which was resolved within 48 hours. Twenty-four patients underwent LC before or after EBS . The remaining 9 patients did not undergo LC due to a poor-risk statu s for general anesthesia. None of them, however, experienced cholecyst itis or colicky attacks after EBS. The combination of EBS and LC is an excellent method for treating cholecysto-choledocholithiasis.