Controlled radial expansion balloon

Follow-up endoscopy was performed every two weeks. If an endoscope of 9.2 mm in diameter could not pass through the esophagus, EBD was performed using a controlled radial expansion balloon (Boston Scientific, Marlborough, MA, USA). The size of the dilators that was used for the initial procedure ranged from 12 to 15 mm, according to the degree of the stricture.

Duodenal side-viewing endoscopes (JF-260, TJF-240, or TJF-260; Olympus, Tokyo, Japan) were used to perform the ERCP procedure. The patients were under midazolam sedation. Sphincterotomy was performed using a standard sphincterotome and/or a needle knife. Balloon sphincteroplasty was performed using a Boston Scientific controlled radial expansion balloon with a diameter range of 12–15 mm, 15–18 mm or 18–20 mm). Stones were extracted using retrieval baskets and/or balloon-tipped catheters. An endoscopic mechanical lithotripsy or laser lithotripsy was attempted to crush down the stones if the stones were too big to remove. Obstructive jaundice resulting from malignant bile duct stenosis was treated by placing nasobiliary drainage (ENBD), plastic stents, or self-expandable biliary metal stents. The benign biliary stricture was treated by dilation or placement of plastic stents or fully covered self-expandable biliary metal stents. Pancreaticobiliary maljunction or pancreas divisum was treated by placing ENBD or plastic stents.