Biliary decompression by nasobiliary catheter or biliary stent in acute suppurative cholangitis: A prospective randomized trial

摘要: Abstract Background: Endoscopic drainage has replaced emergent surgery for biliary decompression in patients with acute cholangitis. The aim of this study was to prospectively compare the efficacy nasobiliary catheter and indwelling stent as temporary measures suppurative cholangitis caused by bile duct stones. Methods: Over a 60-month period, 79 who required endoscopic were recruited. Indications urgent included any one following: temperature greater than 39°C, septic shock systolic blood pressure less 90 mm Hg, increasing abdominal pain, impaired level consciousness. Patients had previously undergone sphincterotomy or coexisting intrahepatic stones excluded. After successful cannulation, randomized receive either without decompression. Outcome procedure time, complications, clinical response, patient discomfort (scored 10-cm, unscaled visual analog score). Results: Of patients, 5 excluded because previous stones, 40 (NBC group), 34 (stent group). Demographic data similar between groups. All procedures NBC group; there failure group. mean (SD) time group 14.0 [9.3] minutes vs. 11.4 [7.2] min). There 2 ERCP-related complications Four pulled out became kinked. One occluded. significantly lower score on day 1 after 1.8 [2.6] 3.9 [2.7]; p = 0.02 t test). overall mortality rate 6.8% (2.5% 12% Conclusion: equally effective associated postprocedure avoided potential problem inadvertent removal catheter. (Gastrointest Endosc 2002;56:361-5.)