Clinical usefulness of a new 4 Fr ENBD catheter

Abstract

Forty six patients with obstructive jaundice who underwent endoscopic nasobiliary drainage (ENBD) using either a 4 Fr or 6 Fr catheter without endoscopic sphincterotomy were enrolled and divided into two groups according to catheter size. Clinical outcomes were compared between the two groups. Bile output, decrease in bilirubin level, and number of days to reduce bilirubin by 50% were similar in the groups. The incidence of pancreatic-type hyperamylasemia was less in 4 Fr group (13.0% versus 34.8%, p=0.10). Post-procedure pancreatitis was seen in 1 patient in 6 Fr group. No patient in the 4 Fr group developed pancreatitis. Nose/throat discomfort on the procedure day scored by a visual analog scale (0, no discomfort; 10, severe discomfort) were 2.5 and 4.4 in the 4 Fr and 6 Fr groups (P=0.030), respectively. The following day, the scores were 2.1 and 3.7 (P=0.056). In conclusion, a 4 Fr ENBD catheter has equal drainage capacity, less adverse effects on the pancreas, and less nose/throat discomfort compared with the 6 Fr catheter.