Abstract
The long-term prognosis of cases treated for bile duct stones by endoscopic papillary balloon dilation (EPBD)5 years earlier was evaluated. The duration of the ebservation of 101 subjects was 87.3±26.5 months and early complication was limited to pancreatitis (2 cases,2.0 %). For late complications, the recurrence of bile duct stones was noted in 5 cases (5.0%). In 4 of these 5 cases, these stones were believed to have escaped from the gallbladder. No incidence of cholecystitis was recognized nor were there pneumobilia detected in the imaging diagnoses. Four patients succumbed, their causes of death being pancreatic cancer, intrahepatic cholangiocarcinoma, hepatic failure and myocardial infarction. Their survival ranged from 25 to 34 months. When a gallbladder that contains stones is preserved, the possibility of their repeated escape presents a problem. Therefore cholecystectomy should be performed if possible following EPBD. On the other hand, the incidence of cholecystitis is low after EPBD and this approach should be considered as the first choice for the treatment of bile duct stones in cases indicating a high risk for cholecystectomy.
