REMOVING BILE DUCT STONES IN A BILLROTH II GASTRECTOMY PATIENT WITH ENDOSCOPIC BALLOON DILATION OF THE SPHINCTER OF ODDI

Abstract

A 46-year-old man was introduced to Shinshu university hospital in May 1995 with a complain of recurring hypochondralgia due to cholelithiasis. He had received Billroth II gastrectomy at 31 years old. Endoscopic retrograde chorangiopancreatography showed a bile duct stone of 8 mm in diameter, and we performed endoscopic removal of bile duct stone with balloon dilation of the sphincter of Oddi. After diagnostic cholangiography, a balloon-tipped biliary catheter was positioned across the papilla and inflated for dilating the sphincter of Oddi. The papilla was sufficiently dilated to extract the stone easily with a retrieval balloon catheter. After the procedure, the serum amylase level was elevated (369U/l), but pancreatitis did not occur. There was no other associated complications. This technique was useful to remove the stone safely and easily in this case.