Clinical study of trans-T tube duodenal papilla balloon dilatation: a novel procedure for postsurgical residual common bile duct stone

Abstract

To investigate the safety and efficacy of trans-T tube duodenal papilla balloon dilatation for the removal of residual common bile duct stone after choledocholithotomy and T tube drainage. Thirteen cases with residual common bile duct stone treated with trans-T tube duodenal papilla balloon dilatation in our department from June 2010 to April 2012 were analyzed retrospectively. Record CA19-9, bilirubin and albumin before the procedure, 1 week and 1 month later. Check if immediate complications occurs, including hemorrhage, perforation, pancreatitis and cholangitis. During the following up for 2 years, stone recurrence, reflux cholangitis and other long-term complications were observed. Analyze the changes of indicators between preoperative and postoperative and the correlation. All of the 13 patients were treated successfully. 11 patients underwent one procedure, and 2 patients received twice or more times of procedures. CA19-9 decreased significantly 1 week later and 1 month later compared with those before the procedure, while ALB was opposite. Incidences of biliary tract infection and hemorrhage were 1 and 1 respectively. No severe complications occurred, including perforation of gastrointestinal or biliary tract. Incidences of recurrent stone and reflux cholangeitis were 2 and 1 in two years after the procedure. Trans-T tube duodenal papilla balloon dilatation is a safe and effective procedure for patients with recurrent common bile duct stone after choledocholithotomy and T-tube drainage. For the cases which could not be handled with endoscopic procedures, it provides a new therapeutic approach.