Dilation of high-grade pancreatic and biliary ductal strictures with small-caliber angioplasty balloons

Background: Pancreatic and bile duct strictures may be too stenotic to allow passage of conventional endoscopic dilators. Methods: Four patients with strictures (3 pancreatic, 1 biliary) that could not be traversed with conventional endoscopic dilating devices, or in 1 case by a Soehendra stent extractor, underwent stricture dilation with a 3.3F peripheral angioplasty balloon to a maximum diameter of 6 mm. Observations: All strictures in the 4 patients were successfully traversed and dilated and stents were placed with resolution of the presenting clinical problem. Conclusions: Small-caliber angioplasty balloons are useful for dilation with subsequent stent placement of pancreatic and biliary strictures that are refractory to standard endoscopic approaches.