Endoscopic papillary large balloon dilation following biliary stent-guided endoscopic sphincterotomy for a large common bile duct stone in a patient with Billroth II gastrectomy

Abstract

An 86-year-old female visited an emergency department for epigastric pain and fever. She had received Billroth II gastrectomy due to gastric cancer 32 years ago. Laboratory tests revealed elevated levels of hepatobiliary enzymes. Computed tomography showed a common bile duct stone with a diameter of 20 mm. We performed endoscopic retrograde cholangiopancreatography. In the first session, endoscopic needle-knife sphincterotomy under the biliary stent was performed. In the second session, stone removal was completed after endoscopic papillary large balloon dilation. There were no complications associated with the procedure.

We successfully performed endoscopic papillary large balloon dilation with endoscopic sphincterotomy in a patient with previous Billroth II gastrectomy.