Balloon Sphincteroplasty in Pediatric Laparoscopic Common Bile Duct Exploration

Space: StayCurrentMD Author: Maggie E. Bosley, Michaela W.G. Gaffley, Kristen A. Zeller, Leah M. Sieren, John K. Petty, Thomas Pranikoff, Lucas P. Neff Published:

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Maggie E. Bosley, Michaela W.G. Gaffley, Kristen A. Zeller, Leah M. Sieren, John K. Petty, Thomas Pranikoff, Lucas P. Neff

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Abstract

The management of choledocholithiasis in children and teenagers is often a two-procedure process with laparoscopic cholecystectomy (LC) and either pre- or post-operative endoscopic retrograde cholangiopancreatography (ERCP). The addition of laparoscopic common bile duct exploration (LCBDE) during LC can provide definitive treatment for choledocholithiasis during a single anesthetic event. In an effort to minimize sedation and radiation exposure from fluoroscopy, we have employed dilating balloons via a transcystic approach to stretch the sphincter of Oddi with subsequent ductal flushing. We describe the technique of balloon sphincteroplasty as a straightforward adjunct within the pediatric surgeon's skill set to manage choledocholithiasis during LC and our clinical experience.

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