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Endoscopic Sphincterotomy and Endoscopic Papillary Balloon Dilatation for Bile Duct Stones

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New Challenges in Gastrointestinal Endoscopy

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Abstract

Since its development in the early 1970s, endoscopic sphincterotomy (EST) has been playing a pivotal role in the treatment of bile duct stones. With various advances in technology, nearly 100% of patients with bile duct stones can be successfully treated by EST. Its major drawback is that hemorrhage, perforation, or pancreatitis can develop, and minimizing procedure-related complications is of great concern for biliary endoscopists. Endoscopic papillary balloon dilatation (EPBD) was developed 10 years after EST as a possible solution to these issues. Although the success rate of duct clearance with EPBD is comparable to that of EST, postprocedure pancreatitis is more frequent than in EST, as has been shown by several randomized controlled trials. Whether or not EPBD lowers the risk of recurrent stones in the long term by avoiding, disruption of the sphincter of Oddi is the crucial point for this procedure to be widely accepted. Recently, the combined use of EST with large balloon dilation has been receiving attention. The benefit of this combination should be clarified by randomized controlled trials with appropriate patient selection. In addition, an increasing number of alternatives to EST and EPBD have been reported in recent years, and these will expand the role of endoscopists in the management of bile duct stones.

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Authors and Affiliations

  1. Department of Gastroenterology, Sendai City Medical Center, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, Miyagi, 983-0824, Japan

    Naotaka Fujita, Yutaka Noda & Kei Ito

Authors
  1. Naotaka Fujita
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  2. Yutaka Noda
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  3. Kei Ito
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Editor information

Editors and Affiliations

  1. Japan Gastroenterological Endoscopy Society, 3-22 Kanda Ogawa-machi, Chiyoda-ku, Tokyo, 101-0052, Japan

    Hirohumi Niwa M.D. (President, Professor of Medicine) (President, Professor of Medicine)

  2. St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, 216-8511, Japan

    Hirohumi Niwa M.D. (President, Professor of Medicine) (President, Professor of Medicine)

  3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Hisao Tajiri M.D. (Professor) (Professor)

  4. Kyoto Second Red Cross Hospital, 355-5 Kamanza-dori, Maruta-machi-agaru, Kamigyo-ku, Kyoto, 602-8026, Japan

    Masatsugu Nakajima M.D. (President) (President)

  5. Department of Gastroenterology, Kyoto Second Red Cross Hospital, 355-5 Kamanza-dori, Maruta-machi-agaru, Kamigyo-ku, Kyoto, 602-8026, Japan

    Kenjiro Yasuda M.D. (Director) (Director)

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Fujita, N., Noda, Y., Ito, K. (2008). Endoscopic Sphincterotomy and Endoscopic Papillary Balloon Dilatation for Bile Duct Stones. In: Niwa, H., Tajiri, H., Nakajima, M., Yasuda, K. (eds) New Challenges in Gastrointestinal Endoscopy. Springer, Tokyo. https://doi.org/10.1007/978-4-431-78889-8_37

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  • DOI: https://doi.org/10.1007/978-4-431-78889-8_37

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-78888-1

  • Online ISBN: 978-4-431-78889-8

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