Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2016; 8(18): 646-652
Published online Oct 16, 2016. doi: 10.4253/wjge.v8.i18.646
Efficacy and safety of endoscopic papillary balloon dilation for the removal of bile duct stones: Data from a “real-life” multicenter study on Dilation-Assisted Stone Extraction
Roberto Di Mitri, Filippo Mocciaro, Socrate Pallio, Giulia Maria Pecoraro, Andrea Tortora, Claudio Zulli, Simona Attardo, Attilio Maurano
Roberto Di Mitri, Filippo Mocciaro, Giulia Maria Pecoraro, Simona Attardo, Gastroenterology and Endoscopy Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127 Palermo, Italy
Socrate Pallio, Andrea Tortora, Endoscopy Unit, Policlinico G. Martino, Messina University, 98122 Messina, Italy
Claudio Zulli, Attilio Maurano, Endoscopy Unit, Amico Gaetano Fucito Hospital, 84045 Mercato San Severino (Salerno), Italy
Author contributions: Di Mitri R and Mocciaro F designed and performed the research and wrote the paper; Mocciaro F and Pecoraro GM contributed to the analysis; Pallio S, Tortora A, Zulli C, Attardo S and Maurano A supervised the report.
Institutional review board statement: This study was approved by the Ethics Committee of the ARNAS Civico-Di Cristina-Benfratelli Hospital, Palermo, Italy.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Roberto Di Mitri, MD, Gastroenterology and Endoscopy Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, Piazza N. Leotta 4, 90127 Palermo, Italy.
Telephone: +39-33-88931234 Fax: +39-09-16663053
Received: June 28, 2016
Peer-review started: July 21, 2016
First decision: August 5, 2016
Revised: August 24, 2016
Accepted: September 7, 2016
Article in press: September 8, 2016
Published online: October 16, 2016
Core Tip

Core tip: Endoscopic papillary large-balloon dilation after endoscopic sphincterotomy resulted effective for “difficult” common bile duct (CBD) stones treatment. This endoscopic technique has gradually spread to the current Dilation-Assisted Stone Extraction (DASE), in which balloon dilation was associated to a full or partial incision of the transverse fold, enhancing stones removal and reducing the risk of complications. Technical and clinical success was of 91% and 87% respectively; 18% of patients experienced a complication (bleeding 9%, pancreatitis 8%, perforation 0.8%). DASE allowed a higher first-session success rate and can be consider a valid alternative to endoscopic sphincterotomy not only for bigger stones of the CBD.