Usability of Endoscopic Nasobiliary Drainage after Endoscopic Removal of Common Bile Duct Stones

Abstract

Background/Aims: We aimed to compare the clinical outcomes between endoscopic nasobiliary drainage (ENBD) group and non-ENBD group after endoscopic common bile duct (CBD) stone extraction.

Methods: From March 2003 to August 2008, a total of 532 patients (282 men; mean age 62.4 years) underwent endoscopic retrograde cholangiopancreatography (ERCP) for CBD stone extraction.

Results: Among 532 patients, CBD stones were completely extracted in 523 patients (98.3%). Among 523 patients, CBD stone were completely extracted by 1st ERCP attempt in 507 patients (96.9%). ENBD-1 group comprised of 28 patients who received ENBD with any indication. ENBD-2 group comprised of 9 patients who received ENBD routinely after complete CBD stone removal. There was no significant difference in occurrence of post ERCP cholangitis or residual CBD stone between ENBD-1 group (n=28) and Non-ENBD-1 group (n=504) (3.6% vs. 2.2%, 3.6% vs. 0.6%, P=0.48 and P=0.08, respectively), and between ENBD-2 group (n=9) and Non-ENBD-2 group (n=500) (0.0% vs. 2.2%, 0.0% vs. 0.8%, P=1.00 and P=1.00, respectively).

Conclusions: Post ERCP cholangitis and residual CBD stone occurred rarely after CBD stone extraction. Therefore routine insertion of ENBD for biliary decompression after CBD stone extraction should be considered prudently.