Abstract:Balloon dilatation of biliary strictures using a peroral cholangioscope was used on 10 patients who had biliary strictures accompanied by proximally located stones. A dilation sufficient for the passage of a cholangioscope was obtained in 8 of 10 patients including all of the 6 patients with extrahepatic strictures and 2 of the 4 patients with intrahepatic ones. After successful dilatation of the strictures, peroral cholangioscopic lithotripsy was performed in 4 of the 8 patients whose gallstones were too large to be removed with a conventional stone basket: electrohydraulic lithotripsy in 3 patients and Nd: YAG Laser lithotripsy in one patient. Complete stone clearance was achieved in 5 patients with extrahepatic strictures. Three patients, 1 with the extrahepatic strictures and 2 with the intrahepatic strictures had partial stone clearance. A follow‐up study (27 months on average) disclosed no recurrence of symptoms or elevated laboratory tests indicative of restrictures. Balloon dilatation with a peroral cholangioscope might be a safe and effective treatment as a new approach for biliary strictures especially for extrahepatic lesions, as an alternative to surgical interventio