Abstract: Japan Gastroenterological Endoscopy Society has developed the ‘EPLBD Clinical Practice Guidelines’ as fundamental guidelines based on new scientific techniques. EPLBD is a treatment  method that has recently become widely used for choledocolithiasis. The evidence level in this field  is usually low, and in many instances, the recommendation grading has to be determined on the  basis of expert consensus. At this point, the guidelines are divided into the following six sections  according to the ‘EST Clinical Practice Guidelines’: ① Indications.EPLBD is indicated for large and multiple stones with bile duct dilatation that  are difficult to treat by EST and EPBD alone. ② Procedures. EPLBD following EST improves the stone removal rate in the first session, and it  might reduce the frequency of mechanical lithotripsy usage. The distal bile duct diameter and the short diameter of the stone are taken into  consideration when selecting the balloon diameter. ③Special cases. In patients with periampullary diverticulum, EPLBD can be performed. EPLBD also can be performed in patients with surgically altered anatomy. ④ Procedurerelated adverse events. The incidence of early adverse events caused by EPLBD is in the range of 0%22.5%, including bleeding, perforation, pancreatitis, and cholangitis.  ⑤Treatment outcomes. The rate of stone removal in EPLBD for gallstones of the common bile duct is from  80.9% to 89% for the initial treatment and ultimately from 95.2% to 100% for the complete stone  removal.The recurrent rate of bile duct stone after EPLBD is 4.4% to 14.5%.  ⑥Postoperative follow up  observation.Delayed adverse events other than recurrent stones of the common bile duct  have an incidence of 0% to 10% and include cholecystitis and cholangitis.

Key words: balloon dilation, guidebooks, cholangiopancreatography, endoscopic retrograde