Système gastro-intestinal et digestif

Abstrait

Efficacy of Endoscopic Nasobiliary Drainage in Consecutive 100 Patients: A Single Center Experience

Fatih Tekin, Omer Ozutemiz, Galip Ersoz, Oktay Tekesin

Objective: The aim of this retrospective study was to assess the efficacy of endoscopic nasobiliary drainage (ENBD) at a tertiary referral center.

Methods: Patients who had been performed ENBD were included in the study.

Results: ENBD was performed in 100 patients (53 female, median age: 46 (17-84)) with biliary leak (n=30), cholangitis (n=67), and iatrogenic duodenal perforation (n=3). The most common etiologies for biliary leak were laparoscopic cholecystectomy (LC) (n=19) and orthotopic liver transplantation (OLT) (n=8). The most common site of biliary leak was found to be cystic duct stump (15/19, 79%) in LC patients, and biliary anastomosis in OLT patients (6/8, 75%). All of the patients with biliary leak (n=30) underwent to endoscopic papillary sphincterotomy (EST). Healing of biliary leak was observed in all patients. Viscous pus in the bile was observed during ERCP procedure in all patients with cholangitis. The most common etiologies for cholangitis were malignant biliary obstruction (n=21), benign biliary stricture (n=18), and bile duct stone (n=14). Of the 67 patients with cholangitis, EST was performed in 64 (95.5%) patients. Recovery was achieved, and second ERCP session or surgical treatment was applicable in all 67 patients with cholangitis.

Conclusions: ENBD with EST is efficient and safe to treat both the postoperative biliary leaks and the lifethreating cholangitis, and gives chance to perform subsequent definite treatments in patients with cholangitis.