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From May 1996 through August 1998, endoscopic papillary balloon dilation (EPBD) was performed to remove common bile duct stones in 17 elderly patients, aged 75 to 87 (average 81.9), including 7 with juxtapapillary diverticulum. The balloon-tipped biliary catheter for EPBD was inflated at a pressure of 10 atm, for 2 minutes, and the maximum diameter of the inflated balloon reached 8 or 10 mm. After one or two ERCP sessions using EPBD alone, the bile duct stones were removed in 16 (94.1%) of 17 patients, and endoscopic mechanical lithotripsy was required in 6 (35.3%) patients. Another patient required additional sphincterotomy for removal of the stone. Massive bleeding or intestinal perforation, which can be major complications of EPBD, did not occur, and while the minor complication of transient abdominal pain was observed in 3 patients but there was no case of pancreatitis. The clearance rates of stones and complication rates in our EPBD procedure were similar to other reports and to those of our data in younger patients, aged under 75. EPBD was a safe and effective technique for the extraction of the common bile duct stones in elderly patients.

Efficacy and Safety of Endoscopic Papillary Balloon Dilation for Removal of Common Bile Duct Stones in the Elderly.