Is it necessary to perform sphincterotomy prior to endoscopic papillary large balloon dilation?

Abstract

Endoscopic papillary large balloon dilation (EPLBD) has already been a popular technique, which enabled easy removal of common bile duct stones even in cases with large and multiple stones. Originally, this technique has been attempted in cases after failed stone removal following endoscopic sphincterotomy (EST). Therefore, it has been a standard technique to perform EST prior to EPLBD. On the other hand, the technique of EPLBD without EST was recently introduced and the several study results have been reported. The previous studies suggested that the efficacy and safety were comparable regardless of performing EST. However, there have been only a few randomized controlled trials to compare the treatment outcomes between the two techniques. Therefore, further evaluation is requested to conclude whether EST is necessary prior to EPLBD.