Endoscopic nasobiliary drainage in acute suppurative cholangitis.
BACKGROUND
Acute suppurative cholangitis is associated with significant mortality. It is best managed by drainage of the biliary tree, endoscopic, percutaneous or surgical.


OBJECTIVE
To study the effect of emergency endoscopic nasobiliary drainage (ENBD) in acute suppurative calculous cholangitis.


METHODS
In 37 patients with calculous cholangitis, an endoscopic nasobiliary drain (7 F) was placed in the biliary tree above the site of obstruction to ensure continuous biliary drainage.


RESULTS
Success rate was 100% and there was no mortality. ENBD was performed in 4 very sick patients without the aid of fluoroscopy. Cholangitis improved in 36 of 37 patients within 12-24 hours. When the clinical condition improved, all the 36 patients were taken up for elective biliary surgery or endoscopic sphincterotomy and stone extraction.


CONCLUSIONS
Emergency endoscopic nasobiliary drainage is an effective method in managing patients with acute suppurative calculous cholangitis.
Chawla
Y K
YK
Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh.
Sharma
B C
BC
Dilawari
J B
JB
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000601:surgery*; D002769:Cholelithiasis / Q000150:complications; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013492:Suppuration