{"id":3909,"date":"2019-11-12T09:00:17","date_gmt":"2019-11-12T09:00:17","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/uncategorized\/dilatacao-balonada-da-papila\/"},"modified":"2023-12-03T21:57:35","modified_gmt":"2023-12-03T21:57:35","slug":"dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/","title":{"rendered":"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis"},"content":{"rendered":"<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2016\/11\/dilatacao-balonada-papila.png\" data-rel=\"penci-gallery-image-content\" ><img decoding=\"async\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2016\/11\/dilatacao-balonada-papila.png\" alt=\"\" class=\"wp-image-7133\"\/><\/a><\/figure>\n<\/div>\n\n\n<p>Colelit\u00edase est\u00e1 presente em cerca de 10-20 % da popula\u00e7\u00e3o americana, sendo que 10-15 % destes pacientes ir\u00e3o cursar com coledocolit\u00edase (1).<\/p>\n\n\n\n<p>Mais de 90% dos c\u00e1lculos de col\u00e9doco s\u00e3o extra\u00eddos apenas com papilotomia e varredura. Por\u00e9m 10 % das coledocolit\u00edases s\u00e3o representadas por c\u00e1lculos gigantes (&gt; 15 mm), que geralmente necessitam de procedimentos adicionais \u00e0 papilotomia para sua extra\u00e7\u00e3o.<\/p>\n\n\n\n<p>V\u00e1rios trabalhos na literatura comprovam que a dilata\u00e7\u00e3o da papila com bal\u00e3o ap\u00f3s papilotomia \u00e9 uma t\u00e9cnica simples,&nbsp; segura e eficaz no tratamento dos c\u00e1lculos gigantes de col\u00e9doco, substituindo na maioria dos casos a tradicional litotripsia mec\u00e2nica. Acrescenta-se que \u00e9 uma t\u00e9cnica mais r\u00e1pida, fato que diminui a quantidade de radia\u00e7\u00e3o a qual o paciente \u00e9 exposto durante o procedimento(2,3).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-indicacoes\"><strong>Indica\u00e7\u00f5es:<\/strong><\/h2>\n\n\n\n<p>Presen\u00e7a de c\u00e1lculos de col\u00e9doco gigantes ou n\u00e3o, quando a papilotomia n\u00e3o foi suficiente para permitir a retirada do c\u00e1lculo.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-contraindicacao\"><strong>Contraindica\u00e7\u00e3o:<\/strong><\/h2>\n\n\n\n<p>A principal contraindica\u00e7\u00e3o deste procedimento \u00e9 a presen\u00e7a de despropor\u00e7\u00e3o acentuada entre o c\u00e1lculo e o col\u00e9doco distal, seja pela presen\u00e7a de estenose ou n\u00e3o.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-tecnica\"><strong>T\u00e9cnica<\/strong><\/h2>\n\n\n\n<p>A t\u00e9cnica consiste na realiza\u00e7\u00e3o da papilotomia seguido da passagem do bal\u00e3o dilatador transpapilar, mantendo-o 80% da sua extens\u00e3o dentro do col\u00e9doco, e 20% na luz duodenal.<\/p>\n\n\n\n<p>A escolha do di\u00e2metro do bal\u00e3o depende do tamanho do c\u00e1lculo e da via biliar distal:<\/p>\n\n\n\n<ul class=\"has-very-light-gray-to-cyan-bluish-gray-gradient-background has-background wp-block-list\">\n<li>C\u00e1lculo\/ col\u00e9doco distal 12-14 mm: bal\u00e3o 12-15 mm<\/li>\n\n\n\n<li>C\u00e1lculo\/ col\u00e9doco distal 15-17 mm: bal\u00e3o 15-18 mm<\/li>\n\n\n\n<li>C\u00e1lculo\/ col\u00e9doco distal 18-20 mm: bal\u00e3o 18-20 mm<\/li>\n<\/ul>\n\n\n\n<p>O bal\u00e3o \u00e9 preenchido com contraste para avalia\u00e7\u00e3o da cintura radiol\u00f3gica e insuflado at\u00e9 o di\u00e2metro desejado de acordo com a press\u00e3o indicada no bal\u00e3o. O desaparecimento da cintura indica a ruptura do esf\u00edncter, sendo fundamental para permitir a passagem do c\u00e1lculo.<\/p>\n\n\n\n<p>O tempo de perman\u00eancia do bal\u00e3o insuflado n\u00e3o est\u00e1 padronizado na literatura, podendo ficar entre 30 seg a 3 minutos. A inten\u00e7\u00e3o de n\u00e3o desinsuflar o bal\u00e3o precocemente \u00e9 somente por fins hemost\u00e1ticos, visto que ap\u00f3s o rompimento da &#8220;cintura&#8221;, ou seja, das fibras musculares do esf\u00edncter, n\u00e3o h\u00e1 necessidade de manter o bal\u00e3o insuflado; n\u00e3o \u00e9 isso que far\u00e1 a dilata\u00e7\u00e3o mais efetiva, ao contr\u00e1rio do que muitos colegas ainda acreditam !<\/p>\n\n\n\n<p>Ap\u00f3s a dilata\u00e7\u00e3o da papila retira-se o bal\u00e3o e realiza-se a varredura com bal\u00e3o extrator ou basket.<\/p>\n\n\n\n<p>Importante ressaltar que a dilata\u00e7\u00e3o deve ser precedida pela papilotomia, pois diversos estudos mostram que apenas a dilata\u00e7\u00e3o, sem uma esfincterotomia pr\u00e9via, aumenta muito o \u00edndice de pancreatite.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-comentario\"><strong>Coment\u00e1rio<\/strong><\/h2>\n\n\n\n<p>Pessoal, apesar do post ser sobre dilata\u00e7\u00e3o balonada da papila maior, vou me permitir comentar uma situa\u00e7\u00e3o que vejo ocorrer com frequ\u00eancia mesmo com colegas experientes. \u00c9 sobre a impacta\u00e7\u00e3o do basket (cesto de Dormia) na papila.<\/p>\n\n\n\n<p>Eu N\u00c3O uso basket, a n\u00e3o ser que tenha um litotriptor de emerg\u00eancia dispon\u00edvel durante o procedimento ou que o basket seja do tipo Trapezoid RX, o qual permite a destrui\u00e7\u00e3o dos c\u00e1lculos atrav\u00e9s do acoplamento a uma pistola de press\u00e3o.<\/p>\n\n\n\n<p>J\u00e1 vi diversos colegas em situa\u00e7\u00f5es dif\u00edceis quando o basket fica preso na papila e n\u00e3o \u00e9 poss\u00edvel nem empurr\u00e1-lo e nem tracion\u00e1-lo, fazendo com que na maioria das vezes a resolu\u00e7\u00e3o do caso seja atrav\u00e9s de uma cirurgia (j\u00e1 vi colegas conseguirem passar um bal\u00e3o dilatador em paralelo ao basket impactado e resolver a situa\u00e7\u00e3o, mas isso n\u00e3o \u00e9 o habitual). Nesses casos, quando a cirurgia n\u00e3o pode ser realizada de imediato, o paciente por vezes recebe alta com um fio de a\u00e7o exteriorizado por uma das narinas ou o protegem com um acess\u00f3rio de silicone e o mesmo permanece no est\u00f4mago at\u00e9 que a cirurgia possa ser realizada. Em casos de c\u00e1lculos grande o risco dessa complica\u00e7\u00e3o \u00e9 ainda maior ! Minha conduta nessas situa\u00e7\u00f5es \u00e9 a passagem de uma pr\u00f3tese pl\u00e1stica e agendamento de uma segunda abordagem em 6 semanas. Diversas vezes me surpreendi com a grande diminui\u00e7\u00e3o do tamanho do c\u00e1lculo causado pelo atrito com a pr\u00f3tese ap\u00f3s esse per\u00edodo, o que tornou a extra\u00e7\u00e3o muito mais f\u00e1cil e segura.<\/p>\n\n\n\n<p>Recentemente com a introdu\u00e7\u00e3o em nossa pr\u00e1tica di\u00e1ria do SpyGlass, o qual possibilita a fragmenta\u00e7\u00e3o e remo\u00e7\u00e3o desses c\u00e1lculos sem maiores problemas, n\u00e3o vejo o porqu\u00ea correr o risco de uma impacta\u00e7\u00e3o com o uso do basket. De qualquer forma, essas situa\u00e7\u00f5es citadas anteriormente s\u00e3o exce\u00e7\u00f5es, e\u00a0taxa de sucesso na remo\u00e7\u00e3o dos c\u00e1lculos gigantes atrav\u00e9s de uma esf\u00edncterotomia associada \u00e0 dilata\u00e7\u00e3o atinge cifras de 95% com \u00edndice de complica\u00e7\u00f5es n\u00e3o superiores a pacientes que realizam apenas a esficterotomia (4).<\/p>\n\n\n\n<details class=\"wp-block-details has-very-light-gray-to-cyan-bluish-gray-gradient-background has-background is-layout-flow wp-block-details-is-layout-flow\"><summary>Saiba mais conferindo esses artigos relacionados<\/summary>\n<figure class=\"wp-block-embed is-type-wp-embed is-provider-endoscopia-terapeutica wp-block-embed-endoscopia-terapeutica\"><div class=\"wp-block-embed__wrapper\">\n<blockquote class=\"wp-embedded-content\" data-secret=\"NMiBlUFX9c\"><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/tratamento-endoscopico-dos-calculos-biliares-dificeis\/\">Tratamento endosc\u00f3pico dos c\u00e1lculos biliares dif\u00edceis<\/a><\/blockquote><iframe class=\"wp-embedded-content\" sandbox=\"allow-scripts\" security=\"restricted\" style=\"position: absolute; visibility: hidden;\" title=\"&#8220;Tratamento endosc\u00f3pico dos c\u00e1lculos biliares dif\u00edceis&#8221; &#8212; Endoscopia Terapeutica\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/tratamento-endoscopico-dos-calculos-biliares-dificeis\/embed\/#?secret=pMDdHKtThf#?secret=NMiBlUFX9c\" data-secret=\"NMiBlUFX9c\" width=\"600\" height=\"338\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\"><\/iframe>\n<\/div><\/figure>\n\n\n\n<p><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/video\/dilatacao-balonada-da-papila-duodenal\" target=\"_blank\" rel=\"noreferrer noopener\">Video: dilatacao-balonada-da-papila-duodenal<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/?p=15914\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/endoscopiaterapeutica.net\/pt\/litotripsia-intraductal-na-colangiopancreatografia-retrograda-endoscopica\/<\/a><\/p>\n<\/details>\n\n\n\n<div style=\"height:68px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-referencias\"><strong>Refer\u00eancias<\/strong><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Everhart JE, Khare M, Hill M, Maurer KR. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10464139\">Prevalence and ethnic differences in gallbladder disease in the United States.<\/a> 1999 Sep;117(3):632-9.<\/li>\n\n\n\n<li>Itoi T, Itokawa F, Sofuni A <em>et al. <\/em>Endoscopic sphincterotomy combined with large balloon dilation can reduce the procedure time and fluoroscopy time for removal of large bile duct stones. Am J Gastroenterol 2009;104:560\u20135.<\/li>\n\n\n\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Stefanidis%20G%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=21045816\">Stefanidis G<\/a>, <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Viazis%20N%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=21045816\">Viazis N<\/a>, <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Pleskow%20D%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=21045816\">Pleskow D<\/a>, <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Manolakopoulos%20S%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=21045816\">Manolakopoulos S<\/a>, <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Theocharis%20L%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=21045816\">Theocharis L<\/a>, <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Christodoulou%20C%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=21045816\">Christodoulou C<\/a>, et al. Large balloon dilation vs. mechanical lithotripsy for the management of large bile duct stones: a prospective randomized study. Am J Gastroenterol. 2011 Feb;106(2):278-85.<\/li>\n\n\n\n<li>Shim C, Kim JW, Lee TY, Cheon YK .Is Endoscopic Papillary Large Balloon Dilation Safe for Treating Large CBD Stones? Saudi Gastroenterol 2016;22(4):251-9<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Colelit\u00edase est\u00e1 presente em cerca de 10-20 % da popula\u00e7\u00e3o americana, sendo que 10-15&hellip;<\/p>\n","protected":false},"author":4256,"featured_media":3910,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[151],"tags":[],"ano":[145],"tipo":[155],"volume":[147],"class_list":["post-3909","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-assuntosgerais","ano-145","tipo-cpre","volume-volume-ii"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis &#8226; Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis\" \/>\n<meta property=\"og:description\" content=\"Colelit\u00edase est\u00e1 presente em cerca de 10-20 % da popula\u00e7\u00e3o americana, sendo que 10-15 % destes pacientes ir\u00e3o cursar com coledocolit\u00edase (1). Mais de 90%\" \/>\n<meta property=\"og:url\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/\" \/>\n<meta property=\"og:site_name\" content=\"Endoscopia Terapeutica\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/endoscopiaterapeutica\" \/>\n<meta property=\"article:published_time\" content=\"2019-11-12T09:00:17+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-12-03T21:57:35+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2016\/11\/dilatacao-balonada-papila.png\" \/>\n\t<meta property=\"og:image:width\" content=\"535\" \/>\n\t<meta property=\"og:image:height\" content=\"521\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Renzo Feitosa Ruiz\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Renzo Feitosa Ruiz\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/\"},\"author\":{\"name\":\"Renzo Feitosa Ruiz\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#\\\/schema\\\/person\\\/32a0cde19cd69e63a6e27bb170003484\"},\"headline\":\"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis\",\"datePublished\":\"2019-11-12T09:00:17+00:00\",\"dateModified\":\"2023-12-03T21:57:35+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/\"},\"wordCount\":995,\"commentCount\":6,\"publisher\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2016\\\/11\\\/dilatacao-balonada-papila.png\",\"articleSection\":[\"Assuntos Gerais\"],\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/\",\"name\":\"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis &#8226; Endoscopia Terapeutica\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2016\\\/11\\\/dilatacao-balonada-papila.png\",\"datePublished\":\"2019-11-12T09:00:17+00:00\",\"dateModified\":\"2023-12-03T21:57:35+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/#breadcrumb\"},\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/#primaryimage\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2016\\\/11\\\/dilatacao-balonada-papila.png\",\"contentUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2016\\\/11\\\/dilatacao-balonada-papila.png\",\"width\":535,\"height\":521},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#website\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/\",\"name\":\"Endoscopia Terapeutica\",\"description\":\"O Jornal Endoscopia Terap\u00eautica tem como objetivo compartilhar experi\u00eancias da pr\u00e1tica di\u00e1ria, al\u00e9m de prover atualiza\u00e7\u00f5es e discuss\u00f5es sobre endoscopia digestiva.\",\"publisher\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pt-BR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#organization\",\"name\":\"Endoscopia Terapeutica\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2023\\\/09\\\/endter.jpg\",\"contentUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2023\\\/09\\\/endter.jpg\",\"width\":720,\"height\":721,\"caption\":\"Endoscopia Terapeutica\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/endoscopiaterapeutica\",\"https:\\\/\\\/www.instagram.com\\\/endoscopy\\\/\",\"https:\\\/\\\/www.youtube.com\\\/@endoscopyonline\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#\\\/schema\\\/person\\\/32a0cde19cd69e63a6e27bb170003484\",\"name\":\"Renzo Feitosa Ruiz\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/0fd51753f465ec31ea2123b54b91a8a5e1b5f7cdd0fe3832cf4b790c9ec7fb2d?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/0fd51753f465ec31ea2123b54b91a8a5e1b5f7cdd0fe3832cf4b790c9ec7fb2d?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/0fd51753f465ec31ea2123b54b91a8a5e1b5f7cdd0fe3832cf4b790c9ec7fb2d?s=96&d=mm&r=g\",\"caption\":\"Renzo Feitosa Ruiz\"},\"description\":\"Doutorado pelo Depto. de Gastroenterologia da Faculdade de Medicina da USP Especializa\u00e7\u00e3o em Motilidade Digestiva pelo Depto. de Gastroenterologia da Faculdade de Medicina da USP M\u00e9dico do Servi\u00e7o de Endoscopia Digestiva do Hospital Israelita Albert Einstein M\u00e9dico do Servi\u00e7o de Endoscopia Digestiva do Hospital Alem\u00e3o Oswaldo Cruz\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/author\\\/renzo\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis &#8226; Endoscopia Terapeutica","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/","og_locale":"pt_BR","og_type":"article","og_title":"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis","og_description":"Colelit\u00edase est\u00e1 presente em cerca de 10-20 % da popula\u00e7\u00e3o americana, sendo que 10-15 % destes pacientes ir\u00e3o cursar com coledocolit\u00edase (1). Mais de 90%","og_url":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/","og_site_name":"Endoscopia Terapeutica","article_publisher":"https:\/\/www.facebook.com\/endoscopiaterapeutica","article_published_time":"2019-11-12T09:00:17+00:00","article_modified_time":"2023-12-03T21:57:35+00:00","og_image":[{"width":535,"height":521,"url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2016\/11\/dilatacao-balonada-papila.png","type":"image\/png"}],"author":"Renzo Feitosa Ruiz","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Renzo Feitosa Ruiz","Est. tempo de leitura":"5 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/#article","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/"},"author":{"name":"Renzo Feitosa Ruiz","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/32a0cde19cd69e63a6e27bb170003484"},"headline":"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis","datePublished":"2019-11-12T09:00:17+00:00","dateModified":"2023-12-03T21:57:35+00:00","mainEntityOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/"},"wordCount":995,"commentCount":6,"publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2016\/11\/dilatacao-balonada-papila.png","articleSection":["Assuntos Gerais"],"inLanguage":"pt-BR","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/","url":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/","name":"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis &#8226; Endoscopia Terapeutica","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#website"},"primaryImageOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/#primaryimage"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2016\/11\/dilatacao-balonada-papila.png","datePublished":"2019-11-12T09:00:17+00:00","dateModified":"2023-12-03T21:57:35+00:00","breadcrumb":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/#breadcrumb"},"inLanguage":"pt-BR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/"]}]},{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/#primaryimage","url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2016\/11\/dilatacao-balonada-papila.png","contentUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2016\/11\/dilatacao-balonada-papila.png","width":535,"height":521},{"@type":"BreadcrumbList","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/dilatacao-da-papila-duodenal-maior-com-balao-para-remocao-de-calculos-dificeis\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/endoscopiaterapeutica.net\/pt\/"},{"@type":"ListItem","position":2,"name":"Dilata\u00e7\u00e3o da papila duodenal maior com bal\u00e3o para remo\u00e7\u00e3o de c\u00e1lculos dif\u00edceis"}]},{"@type":"WebSite","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#website","url":"https:\/\/endoscopiaterapeutica.net\/pt\/","name":"Endoscopia Terapeutica","description":"O Jornal Endoscopia Terap\u00eautica tem como objetivo compartilhar experi\u00eancias da pr\u00e1tica di\u00e1ria, al\u00e9m de prover atualiza\u00e7\u00f5es e discuss\u00f5es sobre endoscopia digestiva.","publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/endoscopiaterapeutica.net\/pt\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pt-BR"},{"@type":"Organization","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization","name":"Endoscopia Terapeutica","url":"https:\/\/endoscopiaterapeutica.net\/pt\/","logo":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/","url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg","contentUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg","width":720,"height":721,"caption":"Endoscopia Terapeutica"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/endoscopiaterapeutica","https:\/\/www.instagram.com\/endoscopy\/","https:\/\/www.youtube.com\/@endoscopyonline"]},{"@type":"Person","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/32a0cde19cd69e63a6e27bb170003484","name":"Renzo Feitosa Ruiz","image":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/secure.gravatar.com\/avatar\/0fd51753f465ec31ea2123b54b91a8a5e1b5f7cdd0fe3832cf4b790c9ec7fb2d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/0fd51753f465ec31ea2123b54b91a8a5e1b5f7cdd0fe3832cf4b790c9ec7fb2d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/0fd51753f465ec31ea2123b54b91a8a5e1b5f7cdd0fe3832cf4b790c9ec7fb2d?s=96&d=mm&r=g","caption":"Renzo Feitosa Ruiz"},"description":"Doutorado pelo Depto. de Gastroenterologia da Faculdade de Medicina da USP Especializa\u00e7\u00e3o em Motilidade Digestiva pelo Depto. de Gastroenterologia da Faculdade de Medicina da USP M\u00e9dico do Servi\u00e7o de Endoscopia Digestiva do Hospital Israelita Albert Einstein M\u00e9dico do Servi\u00e7o de Endoscopia Digestiva do Hospital Alem\u00e3o Oswaldo Cruz","url":"https:\/\/endoscopiaterapeutica.net\/pt\/author\/renzo\/"}]}},"_links":{"self":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/3909","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/users\/4256"}],"replies":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/comments?post=3909"}],"version-history":[{"count":6,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/3909\/revisions"}],"predecessor-version":[{"id":18023,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/3909\/revisions\/18023"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/media\/3910"}],"wp:attachment":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/media?parent=3909"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/categories?post=3909"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/tags?post=3909"},{"taxonomy":"ano","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/ano?post=3909"},{"taxonomy":"tipo","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/tipo?post=3909"},{"taxonomy":"volume","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/volume?post=3909"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}