%0 Journal Article %T Dilata o Papilar com Bal o de Grande Diametro Precedida de Esfincterotomia para Remo o de C¨¢lculos da Via Biliar Principal: Casu¨ªstica de Um Ano Papillary Large-Balloon Dilation Preceded by Sphincterotomy for Removal of Bile Ducts Stones: One Year Experience %A Ana Catarina Rego %A Nuno Nunes %A Jos¨¦ Renato Pereira %A Nuno Paz %J Jornal Portugu¨ºs de Gastrenterologia %D 2011 %I Sociedade Portuguesa de Gastrenterologia %X INTRODU O: A associa o de dilata o da papila de Vater com bal o TTS-CRE (through the scope-controlled radial expansion) com esfincterotomia (ETE) tem sido usada para remo o de c¨¢lculos de grandes dimens es da via biliar principal (VBP). OBJECTIVOS: Apresenta o da casu¨ªstica do nosso Servi o durante doze meses, em que se procedeu a ETE seguida de dilata o papilar com bal o para remo o de c¨¢lculos da VBP. Pretendeu-se avaliar a efic¨¢cia na remo o dos c¨¢lculos, a necessidade de litotr¨ª-cia mecanica e a ocorr¨ºncia de complica es. M¨¦TODOS: Entre Outubro de 2009 e Setembro de 2010 foi realizada dilata o papilar com bal o precedida de ETE em 25 doentes. Os doentes inclu¨ªdos apresentavam no colangiograma por colangiopancreatografia retr¨®grada endosc¨®pica (CPRE) c¨¢lculos na VBP com dimens o superior ou igual a 10mm. Usaram-se bal es TTS-CRE de 12 a 20mm de diametro. RESULTADOS: Dos 25 doentes, 12 (48%) eram do sexo feminino. A m¨¦dia de idades foi de 73 anos e 65% dos doentes apresentavam dois ou mais c¨¢lculos. O tamanho m¨¦dio dos c¨¢lculos foi de 15mm. Seis doentes apresentavam lit¨ªase residual do col¨¦-doco com ETE pr¨¦via. Em 100% dos casos foi conseguida remo o completa dos c¨¢lculos numa ¨²nica sess o. N o houve necessidade de litotr¨ªcia mecanica. N o se registaram complica es. CONCLUS O: A associa o dos dois m¨¦todos mostrou-se eficaz, r¨¢pida e segura na remo o de c¨¢lculos de grandes dimens es da VBP. INTRODUCTION: Papillary balloon dilation with TTS-CRE balloon (through the scope-controlled radial expansion) in association with sphincterotomy (EST) has been used for removal of large bile duct stones. OBJECTIVES: We present the 12 month experience of our Department wherein we performed a EST followed by papillary balloon dilation for removal of bile duct stones. Efficacy, need for mechanical lithotripsy and occurrence of complications were evaluated. METHODS: Papillary balloon dilation preceded by EST was performed in 25 patients from October 2009 to September 2010. Patients included in the present study had bile duct stones with a diameter greater than or equal to 10mm detected on cholangiogram obtained during endoscopic retrograde cho-langiopancreatography (ERCP). We used TTS-CRE balloons with 12 to 20mm. RESULTS: Of the 25 patients, 12 (48%) were female. Average age was 73 years and 65% of patients had two or more stones. The average size of the stones was 15mm. Six patients had residual bile duct stones with prior EST. In 100% of cases complete removal of the bile duct stones was achieved in a single session. There was no need for mechanical lit %K Dilata o papilar com bal o %K esfincterotomia endosc¨®pica %K c¨¢lculos da via biliar principal %K Papillary balloon dilation %K endoscopic sphincterotomy %K bile duct stones %U http://www.scielo.oces.mctes.pt/scielo.php?script=sci_arttext&pid=S0872-81782011000600004