Staritz et al made the first report about endoscopic papillary balloon dilation (EPBD) for treating bile duct stones in 1983. However EPBD has not gained wide acceptance. Because following study reported that EPBD complications such as pancreatitis were higher than that of endoscopic sphyncterotomy (EST) . However EPBD is recently begining to employ again in treating small bile duct stones instead of EST.
We have introduced EPBD in 17 patients (EPBD group) with bile duct stones from May, 1996. Duodenal papilla were dilated with 8ATM and 8mm balloon for 2 minutes with endoscopic and radiologic guidance. And we have compared efficacy and complications of EPBD with 66 patients (EST group) treated by EST. Maximum size of bile duct stone in EPBD group and EST group is nearly of the same such as 12.8±6.8mm and 14.1±6.9mm. Using EPBD, it is also practicable to remove large bile duct stone after applicating mechanical lithotripsy. There was no perforated cases in EPBD and EST group. Hemorrhage requiring hemostasis, hyperamylasemia and acute pancreatitis is 0%, 17.6%, 0% in EPBD group, and 3.0%, 37.9%, 4.5% in EST group, respectively. That is, efficacy and complications of EPBD is equal to or slightly superior to that of EST.
We concluded that EPBD is one of the best options for treating bile duct stones and will be emploied frequently in the near future.
