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KMID : 0359020070350060451
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Korean Journal of Gastrointestinal Endoscopy
2007 Volume.35 No. 6 p.451 ~ p.155
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Endoscopic Papillary Large Balloon Dilatation for Large Biliary Stones in a Hemodialysis Patient: A Case Report
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Cho Seung-Hyun
Lee Dong-Ki
Lee Byung-Jun
Lim Hyun-Chul
Park Chan-Ik
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Abstract
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In retrieving bile duct stones, full-endoscopic sphincterotomy (EST) with endoscopic mechanical lithotripsy (EML) is considered as a traditional method, and balloon dilation of the papillary sphincter has also been used. Recent studies have reported that mid-EST and endoscopicpapillary large balloon dilatation (EPLBD) was as useful as full-EST with EML, without serious complications. In patients with coagulopathy, such as end-stage renal disease, even a small incision of the sphincter could cause profuse bleeding. In such patients, balloon dilation of the sphincter is a preferred technique over EST. A prior Billroth-II operation renders EST more difficult and increases the risk of a complication. In these patients, the
use of EPBD is also preferred as well. We report a case of successfully retrieving large bile duct stones by EPLBD
without EST, in a patient who had a prior Billroth-II operation, and is undergoing hemodialysis. The patient is free of complications, such as bleeding or acute pancreatitis.
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KEYWORD
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Endoscopic papillary Large balloon dilatation, Mid-endoscopic sphincterotomy, Hemodialysis, Billroth-2
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