Small sphincterotomy combined with papillary dilation with large balloon permits retrieval of large stones without mechanical lithotripsy

AIM： TO introduce a new method： small endoscopic sphincterotomy （ES） combined with endoscopic papillary large balloon dilation （SES ＋ EPLBD） to treat patients with large biliary stones.METHODS： Retrieval of large biliary stones was performed in 88 patients. Mean stone size was 14 ± 3 mm and mean number of stones was 2.5 ± 3.5. Firstly, ES with a small incision was performed. Next, endoscopic papillary dilation was performed with a large balloon to slowly match the size of the bile duct. Stones were then retrieved from the biliary duct with a balloon and a basket.RESULTS： Stone retrieval was successful in all cases except one cystic duct stone case without the need to crush large stones. Mean procedure time was 30 ± 5 min. Dilating the papillary orifice with a large balloon made it possible to remove large stones smoothly without crushing them. After dilation with the large balloon, there were some instances of oozing, but no perforations. One instance of post-procedural pancreatitis （1%） occurred. CONCLUSION： SES ＋ EPLBD was effective for the retrieval of large biliary stones without the use of mechanical lithotripsy.

吹气球，帮你赶走小肚腩

很多人都对自己腰间突出的小肚腩感到烦恼，就算想尽一切办法，也很难赶走它。而吹气球减肥法，或许能带来意想不到的收获。该方法可以通过反复练习达到减肥的目的，这是因为在用力吹气球时，用的是腹式呼吸，在吹大气球时，体温也随之上升，如此对促进脂肪代谢有益。但刚开始时，切勿着急，可能需要吹三四次才能把气球扩张至直径30厘米大，因而需要循序渐进。