Endoscopic retrograde cholangiography with a balloon catheter: analysis of 100 consecutive cases.

One hundred patients whose standard endoscopic retrograde cholangiographic studies gave poor visualization of the biliary tract were investigated using a balloon catheter introduced into the common bile duct by duodenoscopy to block contrast material leakage. Full diagnostic visualization was obtained in 90 patients, leading to accurate diagnosis in 88. In two other patients, the diagnosis was not confirmed. In ten patients the bile ducts were not filled because of balloon size (seven), vagovagal reflex (two), and fistula (one). There were no serious clinical complications. Laboratory studies following the procedure disclosed impaired liver function (three patients), hyperamylasemia (two), and leukocytosis (two) of 41 patients tested, and positive blood culture in three of 81 patients studied. When standard retrograde cholangiography fails to visualize the biliary tract, endoscopic retrograde balloon catheter cholangiography is a useful diagnostic procedure, associated with acceptable minor complications.