Use of 4-Fr versus 6-Fr Nasobiliary Catheter for Biliary Drainage: A Prospective, Multicenter, Randomized, Controlled...

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Biliary Tract Interventions

Background:

• The clinical efficacy of different nasobiliary drainage (NBD) catheter diameters is not well-established.
• Nasobiliary drainage is crucial for managing biliary obstruction and cholangitis.

Purpose of the Study:

• To compare the drainage efficacy and patient comfort between 4-Fr and 6-Fr NBD catheters.
• To evaluate the impact of NBD catheter diameter on technical success, clinical outcomes, and patient-reported discomfort.

Main Methods:

• A prospective, multicenter, randomized controlled study involving 246 patients with cholangitis or cholestasis.
• Patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) were randomized to receive either a 4-Fr or 6-Fr NBD catheter.
• Primary endpoints included technical and clinical success rates; secondary endpoints were catheter displacement and nasal discomfort.

Main Results:

• Technical and clinical success rates were comparable between the 4-Fr and 6-Fr NBD catheter groups.
• No significant difference in spontaneous catheter displacement was observed between the groups.
• Patients with 4-Fr NBD catheters reported significantly less nasal discomfort compared to those with 6-Fr catheters at 24 and 48 hours post-ERCP.

Conclusions:

• The 4-Fr NBD catheter demonstrates non-inferior clinical efficacy compared to the 6-Fr NBD catheter.
• Utilizing a 4-Fr NBD catheter can effectively reduce patient discomfort during biliary drainage procedures.