ERCP, sphincterotomy and immediate vs delayed balloon sphincteroplasty for extraction of large biliary stones – a randomised controlled trial

Removal of bile duct stones requires the sphincter muscle at the bottom of the bile duct to be opened. Usually this involves cutting the muscle. Cutting is insufficient for very large stones and previous standard practice saw patients brought back for a second procedure to stretch the bottom of the bile duct further with a balloon and remove the stones. This thesis shows that combining both cutting and stretching components into a single procedure allows more effective removal of large bile duct stones, compared to delaying the stretch to a second procedure, with identical safety for both approaches.