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Endoscopic nasobiliary drainage in acute suppurative cholangitis
Y K Chawla1, B C Sharma, J B Dilawari
1Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh.
Summary
Emergency endoscopic nasobiliary drainage (ENBD) effectively treats acute suppurative calculous cholangitis with a 100% success rate and no mortality. This minimally invasive procedure offers rapid improvement for critically ill patients.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Biliary Tract Disease
Background:
- Acute suppurative cholangitis presents a high mortality risk.
- Effective management necessitates prompt biliary tree drainage via endoscopic, percutaneous, or surgical approaches.
Purpose of the Study:
- To evaluate the efficacy of emergency endoscopic nasobiliary drainage (ENBD) for acute suppurative calculous cholangitis.
Main Methods:
- 37 patients with calculous cholangitis underwent placement of a 7 French endoscopic nasobiliary drain.
- The drain was positioned above the obstruction to ensure continuous biliary drainage.
Main Results:
- Achieved a 100% success rate with zero mortality.
- 36 out of 37 patients showed clinical improvement within 12-24 hours.
- ENBD was safely performed in critically ill patients, even without fluoroscopy.
Conclusions:
- Emergency endoscopic nasobiliary drainage is a highly effective and safe intervention for acute suppurative calculous cholangitis.
- ENBD facilitates initial stabilization, allowing for subsequent elective biliary surgery or endoscopic stone removal.