Balloon sphincteroplasty and post-sphincterotomy balloon dilation

Endoscopic dilation of the ampulla of Vater, or endoscopic balloon sphincteroplasty, has been practiced by endoscopists for over 25 years. After initial widespread application of the technique, its use has decreased, largely due to concerns of a high incidence of pancreatitis resulting from the dilation. More recently, balloon sphincteroplasty following biliary sphincterotomy has been demonstrated to be safe and effective for management of complex choledocholithiasis. Additionally, there remains a role for endoscopic balloon sphincteroplasty without prior sphincterotomy for select individuals with coagulopathy or anatomy that may preclude endoscopic sphincterotomy.