Efficacy of endoscopic nasobiliary drainage for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis and cholangitis after repeated clearance of common bile duct stones: Experience from a Chinese center

• Published in: Digestive endoscopy 2013-07, Vol.25 (4), p.453-458
• Main Authors: Yang, Jun, Peng, Jia-yuan, Pang, Er-jun, Chen, Wei
• Format: Article
• Language: English
• Subjects: China - epidemiology; Cholangiopancreatography, Endoscopic Retrograde - adverse effects; Cholangiopancreatography, Endoscopic Retrograde - methods; cholangitis; Cholangitis - epidemiology; Cholangitis - etiology; Cholangitis - prevention & control; choledocholithiasis; Choledocholithiasis - surgery; Common Bile Duct - surgery; Drainage - methods; endoscopic nasobiliary drainage (ENBD); endoscopic retrograde cholangiopancreatography (ERCP); Endoscopy, Digestive System - methods; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Nose; pancreatitis; Pancreatitis - epidemiology; Pancreatitis - etiology; Pancreatitis - prevention & control; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Retrospective Studies; Treatment Outcome
• ISSN: 0915-5635; 1443-1661
• DOI: 10.1111/den.12013

Background The aim of the present study was to investigate whether it is reasonable to insert an endoscopic nasobiliary drainage (ENBD) tube in patients with endoscopic sphincterotomy (EST) and repeated clearance of common bile duct (CBD) stones. Patients and methods Patients with choledocholithiasis who underwent EST and CBD stone clearance at our center from January 2010 to May 2012 were reviewed. The following parameters were evaluated: (i) serum amylase 2 and 24 h after ERCP; (ii) incidence of endoscopic retrograde cholangiopancreatography (ERCP)‐related pancreatitis and cholangitis; (iii) time elapsed to normalization of total serum bilirubin levels for those with jaundice before ERCP; and (iv) length of hospital stay. Results Compared with the no‐ENBD group, the ENBD group presented a significantly lower postoperative serum amylase of 2 and 24 h (81.3 ± 31.8 U/L vs 90.8 ± 31.2 U/L, 107.0 ± 51.1 U/Lvs 132.3 ± 100.8 U/L, respectively). The incidence of post‐ERCP pancreatitis and cholangitis was also lower in the ENBD group, although the differences were not significant (1% vs 4.4%, 0 vs 4.5%, respectively). Time elapsed to normalization of total serum bilirubin levels and length of hospital stay was shorter in the ENBD group (4.3 days ± 0.6 days vs 4.5 days ± 0.7 days, P > 0.05; 4.8 days ± 2.1 days vs 6.3 days ± 2.8 days, respectively, P