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Effectiveness and Safety of Balloon Dilation of the Papilla and the Use of an Occlusion Balloon for Clearance of Bile Duct Calculi

Santiago Gil1, Pedro de la Iglesia, José F. Verdú, Francisco de España, Juan Arenas and Javier Irurzun

1 All authors: Department of Radiology, Hospital General Universitario de Alicante, C./ Pintor Baeza s.n., Alicante 03010, Spain.



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  		Fig. 1A. —44-year-old woman who had undergone cholecystectomy 2 months earlier. Cholangiography (not shown) after surgery revealed a single retained calculus. Endoscopic bile stone clearance was not feasible. Cholangiogram through T-tube drainage shows obstructive calculus (arrows) in distal common bile duct.

 


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  		Fig. 1B. —44-year-old woman who had undergone cholecystectomy 2 months earlier. Cholangiography (not shown) after surgery revealed a single retained calculus. Endoscopic bile stone clearance was not feasible. Cholangiogram shows that guidewire has been passed through papilla into duodenum.

 


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  		Fig. 1C. —44-year-old woman who had undergone cholecystectomy 2 months earlier. Cholangiography (not shown) after surgery revealed a single retained calculus. Endoscopic bile stone clearance was not feasible. Cholangiogram shows dilatation of papilla with standard angiographic balloon. Note that balloon is being squeezed by papilla (arrow).

 


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  		Fig. 1D. —44-year-old woman who had undergone cholecystectomy 2 months earlier. Cholangiography (not shown) after surgery revealed a single retained calculus. Endoscopic bile stone clearance was not feasible. Cholangiogram shows occlusion balloon (arrows) pushing calculus.

 


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  		Fig. 1E. —44-year-old woman who had undergone cholecystectomy 2 months earlier. Cholangiography (not shown) after surgery revealed a single retained calculus. Endoscopic bile stone clearance was not feasible. Cholangiogram shows occlusion balloon in duodenum. Calculus has been cleared and is now seen as filling defect (arrows) in duodenum.

 


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  		Fig. 1F. —44-year-old woman who had undergone cholecystectomy 2 months earlier. Cholangiography (not shown) after surgery revealed a single retained calculus. Endoscopic bile stone clearance was not feasible. Cholangiogram 2 days after A-E shows complete clearance of calculus.

 


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  		Fig. 2A. —51-year-old man who had undergone cholecystectomy 2 years earlier and who had several occurrences of cholangitis in last 2 years. Cholangiogram through biliary drainage shows filling defect (arrows) corresponding to biliary calculus.

 


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  		Fig. 2B. —51-year-old man who had undergone cholecystectomy 2 years earlier and who had several occurrences of cholangitis in last 2 years. Cholangiograms show dilatation of papilla with standard angiographic balloon (arrows, B), occlusion balloon (arrow, C) pushing calculus (arrowhead, C), and occlusion balloon in duodenum (D). Calculus has been cleared.

 


View larger version (117K):

[in a new window]
  		Fig. 2C. —51-year-old man who had undergone cholecystectomy 2 years earlier and who had several occurrences of cholangitis in last 2 years. Cholangiograms show dilatation of papilla with standard angiographic balloon (arrows, B), occlusion balloon (arrow, C) pushing calculus (arrowhead, C), and occlusion balloon in duodenum (D). Calculus has been cleared.

 


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[in a new window]
  		Fig. 2D. —51-year-old man who had undergone cholecystectomy 2 years earlier and who had several occurrences of cholangitis in last 2 years. Cholangiograms show dilatation of papilla with standard angiographic balloon (arrows, B), occlusion balloon (arrow, C) pushing calculus (arrowhead, C), and occlusion balloon in duodenum (D). Calculus has been cleared.

 


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  		Fig. 2E. —51-year-old man who had undergone cholecystectomy 2 years earlier and who had several occurrences of cholangitis in last 2 years. Cholangiogram obtained 2 days after A-D shows complete clearance of calculus.

 

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