Balloon-Assisted Stone Extraction (BASE): An Innovative Method for Lithotripsy during Laparoscopic CBD Exploration

Abstract

Background: Balloon-assisted stone extraction (BASE) can be applied to remove the common bile duct (CBD) stones during laparoscopic CBD exploration (LCBDE). Aim: This study aimed to analyze the efficacy of BASE. Methods: A retrospective analysis of patients with CBD stone who underwent LCBDE using BASE at our center from 2001 to 2017, was conducted. The outcomes of BASE and potential factor for failure of this technique were also evaluated. Results: A total of 163 patients underwent LCBDE using BASE for CBD stone were enrolled. Success rate of BASE was 88.3% (144/163) and 19 (11.7%) patients with failed BASE underwent Basket for lithotripsy additionally. The reason for aborting BASE were stone impaction (n=6), small stone (n=4), migration into IHD (n=3), and others (n=6). The overall success rate of stone clearance was 97.5% (159/163). The mean CBD diameter was 15.8 mm (range 7-34 mm), and the largest stone size was 13.8 mm (range 3-36 mm). 22 patients had undergone gastrectomy prior to LCBDE. The overall complication rate was 4.9% (8/163), including bile leakage in 2 patients (1.2%), bleeding in 2 patients (1.2%) and pancreatitis in 4 patients (2.4%). There was no procedure related complication. Conclusions: BASE for CBD stone is safe and effective techniques for the treatment of CBD stones.