Therapeutic endoscopic balloon dilatation of the extrahepatic biliary ducts.

Nine patients with extrahepatic obstructive biliary or pancreatic disease underwent therapeutic endoscopic balloon dilatation over a 24-month period. There were 10 obstructing lesions including common bile duct strictures (six patients), bilioenteric anastomotic strictures (two patients), ampullary stenosis (one patient) and an ampullary neoplasm (one patient). Endoscopic balloon dilatation was performed to relieve cholestasis (five patients), as treatment for cholangitis (one patient), as therapy for acute pancreatitis (one patient), to facilitate delivery of common bile duct stones (one patient), and to allow placement of a biliary endoprosthesis (one patient). The procedure was successful in seven of 12 attempts (58%) and was associated with one major complication (8.0%). Endoscopic balloon dilatation can be an effective palliative therapeutic procedure, with a wide spectrum of use, which may eliminate the need for surgery.