Usefulness of endoscopic papillary balloon dilation for removal of common bile duct stones as compared to endoscopic sphincterotomy.

Endoscopic sphincterotomy (EST) is a commonly used technique for retrieval of common bile duct (CBD) stones. The short-term complications of this technique can include bleeding, perforation, pancreatitis, and cholangitis, and were reported to have a 10% occurrence rate in a multicenter study involving 2347 patients. Endoscopic papillary balloon dilation (EPBD) using balloon diameters of 6e10 mm was first reported by Staritz et al as an alternative endoscopic technique for EST. However, the extent to which EPBD is effective and safe for removal of CBD stones remains controversial. In this issue of the Journal of the Chinese Medical Association, Tsai et al evaluated the clinical efficacy of EPBD in patients with recurrent CBD stones after previous EST. Accordingly, we have reviewed some of the commonly-discussed issues about EPBD versus EST as they relate to the article.