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Medline ® Abstract for Reference 43

of 'Endoscopic management of bile duct stones: Standard techniques and mechanical lithotripsy'

Endoscopic papillary dilation by balloon and isosorbide dinitrate drip infusion for removing bile duct stone.
Minami A, Maeta T, Kohi F, Nakatsu T, Morshed SA, Nishioka M
Scand J Gastroenterol. 1998;33(7):765.
BACKGROUND: Endoscopic papillary dilation (EPD) by balloon in the management of bile duct stones has recently been claimed to be effective for removing bile duct stones.
METHODS: Without endoscopic sphincterotomy, we attempted to remove large or multiple bile duct stones through EPD combined with drip infusion of isosorbide dinitrate in 35 patients. Isosorbide dinitrate, at a rate of 5 mg/h, was administered intravenously, and a balloon dilator with a 10-mm diameter was inflated within 3 min across the papilla. Stones were then smashed using a mechanical lithotriptor, and the fragments were extracted with a basket or the balloon.
RESULTS: Extraction of stones was successful in 33 (94%) of 35 patients by the combined therapy. Two of them (6%) developed mild pancreatitis.
CONCLUSION: EPD combined with medical sphincter dilation was effective for large and multiple bile duct stones.
Third Dept. of Internal Medicine, Kagawa Medical University, Japan.