Researchers found no differences in outcomes between EST alone and EST plus LBD.
Recent studies have suggested that large-balloon dilation (LBD; 12–20 mm) of the biliary orifice after sphincterotomy is an effective method for removing bile-duct stones that cannot be extracted by standard endoscopic sphincterotomy (EST) and a retrieval balloon or basket. To determine the efficacy and safety of EST and LBD, researchers in Korea compared EST plus LBD to EST alone in 200 consecutive patients with bile-duct stones that measured ≤40 mm in diameter. The two groups were similar in baseline characteristics, stone size (mean, 16 mm and 15 mm), and number of stones (mean, 2.7 and 2.2). In the EST-alone group, full-length EST was completed; in the EST-plus-LBD group, EST was limited to one third of the full length, and balloon size…