Early removal of bile duct stones in patients with acute biliary pancreatitis by endoscopic papillary balloon dilatation.

BACKGROUND/AIMS: Endoscopic papillary balloon dilatation has been accepted as a novel alternative to endoscopic sphincterotomy for the management of bile duct stones. Hence, little or no attempt was made to retrieve stones in cases with acute biliary pancreatitis by endoscopic papillary balloon dilatation.

METHODOLOGY: The present study was conducted in ten patients with acute biliary pancreatitis associated with cholestasis or biliary infection. Two patients came with disseminated intravascular coagulopathy, one Child C liver cirrhosis, and another with prolonged prothrombin time of unknown etiology. After the papilla was dilated with a balloon-tipped catheter, the stones were removed with either a retrieval basket catheter, a retrieval balloon, or both.

RESULTS

Clearance of the common bile duct was achieved in all ten patients without any serious complications such as pancreatitis aggravation or hemorrhage. Clinical signs and laboratory findings were strikingly improved in all patients.

CONCLUSIONS

The results suggest that bile duct stones can be effectively and safely removed by means of endoscopic papillary balloon dilatation even in patients with acute pancreatitis.