Prevention of Pancreatitis After Papillary Balloon Dilatation by Nasobiliary Drainage: A Randomized Controlled Trial

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• 作者：Xiao-dan Xu ; Jian-jun Dai ; Jian-qing Qian ; Wei-jun Wang
• 关键词：Endoscopic papillary balloon dilation ; Cholangiopancreatography ; Pancreatitis ; Endoscopic nasobiliary drainage
• 刊名：Digestive Diseases and Sciences
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：60
• 期：4
• 页码：1087-1091
• 全文大小：418 KB
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• 作者单位：Xiao-dan Xu (1)
  Jian-jun Dai (1)
  Jian-qing Qian (1)
  Wei-jun Wang (1)
  
  1. Changshu Affiliated Hospital of Suzhou Universit, Changshu, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gastroenterology
  Hepatology
  Oncology
  Transplant Surgery
  Biochemistry
  
• 出版者：Springer Netherlands
• ISSN：1573-2568

文摘

Background Endoscopic papillary balloon dilation (EPBD) was associated with a higher rate of endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Aim The purpose of this study was to determine whether placement of an endoscopic nasobiliary drainage (ENBD) catheter can also prevent PEP after EPBD. Methods A total of 93 patients, who with proven common bile duct (CBD) stones, received EPBD were enrolled this trial. They were randomly divided into ENBD group (n?=?45) and no-ENBD group (n?=?48) according whether undergone an ENBD procedure after EPBD. Their demographics, laboratory, procedural data were collected, and pancreaticobiliary complications were followed. Results The number of patients with serum amylase levels above the normal upper limit (>180?U/L) did not differ between groups. However, compared with ENBD group, more patients in No-ENBD group had levels greater than three times the normal limit (>540 U/L) (11/48 vs 3/45, P?=?0.0285), and more patients developed to PEP (7/48 vs 0/45, P?=?0.0250). During follow-up, the numbers of patients undergone cholecystectomy, cholangitis and recurrence of CBD stones were similar. There was also no significant difference in the cumulative rate of recurrent pancreaticobiliary complications between the two groups (P?=?0.452). Conclusions EPBD followed by insertion of an ENBD catheter can prevent PEP, and routine ENBD catheter placement is recommended after an EPBD procedure.