Abstract
Rapid and safe biliary decompression is essential for the treatment of acute disease of the biliary tract. Endoscopic nasobiliary drainage (ENBD) is the conventionally used maneuver. Because we have encountered several instances of trouble, including displacement, with the use of drainage tubes, we have come to prefer another endoscopic method, namely, placement of plastic biliary stents. The present study discusses the usefulness of stent placement as compared with that of ENBD in patients with acute biliary disease. We retrospectively examined 32 patients treated by ENBD and 37 patients treated by stent placement at our center between January 2002 and December 2005. We investigated the patient backgrounds, outcomes of the drainage, complications and prognosis. The results revealed no significant differences in the patient backgrounds (the mean age, underlying diseases, etiology and pathology) of the two groups. ENBD and stent placement were equally effective, because the serum level of total bilirubin and CRP decreased almost equally in both the groups after 3 days of drainage. Tube failure occurred significantly frequently in patients treated by ENBD (31.3%) as compared to that in those treated by stent placement (2.7%). There was no difference in the prognosis between the two groups. Since endoscopic biliary stent placement is the same as ENBD in terms of effectiveness and more advantageous with regard to safety, we conclude that it may be considered as the first choice for emergency biliary drainage.
