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Some studies have reported that endo− scopic balloon dilation (EBD) for extract− ing common bile duct stones is associated with higher complication rates in com− parison with endoscopic sphincterotomy (EST) [1], although EBD has been found to be a safe method in other reports [2, 3]. However, it appears that EBD should be used with extreme caution in patients aged 50 years or younger [4], since in rela− tively young and healthy patients, the technique has been associated with in− creased rates of pancreatitis, leading even to death [5]. In this group of pa− tients, the complication rate with EBD ap− pears to be higher than with endoscopic biliary sphincterotomy. The morbidity associated with EBD is presumed to be due to edema or spasm caused by the trauma of dilation, which can lead to tran− sient obstruction of the pancreatic duct and trigger the inflammation cascade of pancreatitis. This effect may be more pro− nounced in young patients, while older ones may have a less severe inflammatory response [6].

Fatal pancreatitis after endoscopic balloon dilation for extraction of common bile duct stones in an 80-year-old woman