Abstract
Removal of large bile duct stones by endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) has been proven safe and effective. Little evidence supports the benefits of a preceding EST in reducing complications. Recent studies suggest that large bile duct stones removal by EPLBD without EST may be safe and effective. Although the procedural success and early complications are similar between EPLBD and EST, EPLBD reduces the use of lithotripsy compared with EST. EPLBD may be an alternative to EST for removal of large or difficult common bile duct stones. However, further investigation is needed to evaluate long-term outcomes after EPLBD.
