Endoscopic papillary large balloon dilation in patients with periampullary diverticula

Figure 1 Endoscopic papillary large balloon dilation in a patient with periampullary diverticulum. A: Cholangiogram showing multiple movable filling defects in the common bile duct; B: Fluoroscopic view showing the disappearance of balloon waist after gradual inflation with contrast media; C: Cholangiogram showing a large stone captured in a basket; D: Cholangiogram showing no residual filling defects in the common bile duct; E: Endoscopic sphincterotomy was carefully performed due to the presence of a huge diverticulum; F: Endoscopic view showing a dilating balloon inflated to 15 mm; G: Endoscopic view showing an enlarged ampullary opening; H: Endoscopic view showing a large brown pigment stone being extracted with a basket.

Figure 2 Endoscopic classification of periampullary diverticula. A: Type 1 with major papilla located inside the diverticulum; B: Type 2 with major papilla located in the margin of the diverticulum; C: Type 3 with major papilla located outside the diverticulum.