Abstract
Endoscopic papillary large-balloon sphincteroplasty (LBS) is increasingly used for large bile duct stones. A preceding endoscopic sphincterotomy (EST) has been considered necessary before LBS to prevent pancreatitis and facilitate stone extraction. A recent study suggested that omission of preceding EST does not increase risk of pancreatitis and may eliminate risk of bleeding. However, its case number was small and involved only patients who underwent LBS without preceding EST.
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