phenylephrine-hydrochloride and Cholangitis

The aim of the present study was to investigate whether it is reasonable to insert an endoscopic nasobiliary drainage (ENBD) tube in patients with endoscopic sphincterotomy (EST) and repeated clearance of common bile duct (CBD) stones.. Patients with choledocholithiasis who underwent EST and CBD stone clearance at our center from January 2010 to May 2012 were reviewed. The following parameters were evaluated: (i) serum amylase 2 and 24 h after ERCP; (ii) incidence of endoscopic retrograde cholangiopancreatography (ERCP)-related pancreatitis and cholangitis; (iii) time elapsed to normalization of total serum bilirubin levels for those with jaundice before ERCP; and (iv) length of hospital stay.. Compared with the no-ENBD group, the ENBD group presented a significantly lower postoperative serum amylase of 2 and 24 h (81.3 ± 31.8 U/L vs 90.8 ± 31.2 U/L, 107.0 ± 51.1 U/Lvs 132.3 ± 100.8 U/L, respectively). The incidence of post-ERCP pancreatitis and cholangitis was also lower in the ENBD group, although the differences were not significant (1% vs 4.4%, 0 vs 4.5%, respectively). Time elapsed to normalization of total serum bilirubin levels and length of hospital stay was shorter in the ENBD group (4.3 days ± 0.6 days vs 4.5 days ± 0.7 days, P > 0.05; 4.8 days ± 2.1 days vs 6.3 days ± 2.8 days, respectively, P < 0.01).. ENBD significantly reduces the incidence of hyperamylasemia and decreases the length of hospital stay in patients with EST and repeated stone extraction. ENBD should be considered for patients with large or multiple CBD stones.

Topics: China; Cholangiopancreatography, Endoscopic Retrograde; Cholangitis; Choledocholithiasis; Common Bile Duct; Drainage; Endoscopy, Digestive System; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Nose; Pancreatitis; Postoperative Complications; Retrospective Studies; Treatment Outcome

Endoscopic retrograde biliary drainage (ERBD) by using a plastic stent is suggested to be as effective as endoscopic nasobiliary drainage (ENBD) for temporary biliary drainage in acute suppurative cholangitis (ASC). However, there are few studies that compared ERBD and ENBD in ASC.. We compared the safety and efficacy of ERBD and ENBD for temporary biliary drainage in patients with ASC.. A case series.. A tertiary-referral center.. Eighty patients with ASC underwent endoscopic biliary drainage with ENBD (n = 41) and ERBD (n = 39).. Clinical outcomes, including complications related to ERCP and complications related to the type of the indwelling catheter.. Endoscopic biliary drainage was successfully achieved in all patients (100%). There were no significant differences in the demographic data between the 2 groups. There were no differences in the improvement of clinical and laboratory parameters between the 2 groups. Overall ERCP-related complication rates in the ENBD and ERBD groups were 31.7% and 38.5%, respectively (P = .527). Hyperamylasemia occurred in 18 patients, 12.2% in the ENBD group (5/41) and 33.3% in the ERBD group (13/39) (P = .024). Without endoscopic sphincterotomy (EST), there was no statistically significant difference in the incidence of hyperamylasemia between the 2 groups. However, with an EST, hyperamylasemia was more frequent in the ERBD group (12/28 [42.9%]) than in the ENBD group (3/27 [11.1%]) (P = .008).. A single-center experience.. Endoscopic biliary decompression, whether by ERBD or ENBD, is an effective treatment for patients with ASC. However, more frequent hyperamylasemia with ERBD and EST deserves further evaluation.

Topics: Acute Disease; Aged; Bile Ducts; Cholangitis; Decompression, Surgical; Drainage; Endoscopy, Digestive System; Female; Humans; Male; Nose; Prosthesis Design; Safety; Stents; Suppuration

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Biliary Tract; Cholangiopancreatography, Endoscopic Retrograde; Cholangitis; Cholestasis, Extrahepatic; Common Bile Duct Diseases; Drainage; Female; Humans; Intubation; Male; Middle Aged; Nose

Topics: Aged; Catheterization; Cholangiopancreatography, Endoscopic Retrograde; Cholangitis; Cholestasis; Common Bile Duct; Drainage; Duodenoscopy; Female; Humans; Male; Middle Aged; Nose