title: Is it necessary to insert a nasobiliary drainage tube routinely after endoscopic clearance of the common bile duct in patients with choledocholithiasis-induced cholangitis? A prospective, randomized trial.
abstract: BACKGROUND
  Little is known about whether a routinely inserted endoscopic nasobiliary drainage (ENBD) tube improves the clinical course in patients with choledocholithiasis-induced acute cholangitis after clearance of choledocholithiasis.
  
  
  OBJECTIVE
  The aim of this study was to investigate the need for ENBD on the clinical outcomes of patients with acute cholangitis undergoing endoscopic clearance of common bile duct (CBD) stones.
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  A total of 104 patients with choledocholithiasis-induced acute cholangitis who underwent primary endoscopic treatment were compared according to insertion of an ENBD tube (51 in the ENBD group and 53 in the no-ENBD group).
  
  
  METHODS
  Insertion of an ENBD tube after clearance of CBD stones.
  
  
  METHODS
  Recurrence of cholangitis and length of hospital stay after clearance of CBD stones.
  
  
  RESULTS
  Baseline clinical characteristics were similar between both groups. There were no significant differences in the recurrence rate of cholangitis at 24 weeks (3.9% for the ENBD group vs 3.8% for the no-ENBD group at 24 weeks; P = .99) and length of hospital stay (7.9 days [standard error = 1.2] for the ENBD group vs 7.9 days [standard error = 0.7] for the no-ENBD group; P = .98). However, procedure time was longer (26.2 [SE = 1.8] minutes vs 22.7 [SE = 1.0] minutes, respectively; P = .01) and the discomfort score was higher (4.9 [SE = 0.4] vs 2.8 [SE = 0.3], respectively; P = .02) in the ENBD group than in the no-ENBD group.
  
  
  CONCLUSIONS
  Single-center study.
  
  
  CONCLUSIONS
  A routinely inserted ENBD tube did not improve the clinical course, despite patients having to endure increased procedure time and discomfort, and the insertion would therefore be unnecessary.
authors.affiliation: Department of Internal Medicine, Dongguk University International Hospital, Dongguk University College of Medicine, Goyang, Gyeonggi-do, Korea. gidoctor@snubh.org
authors.forename: Jun Kyu
authors.initials: JK
authors.lastname: Lee
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.forename: Bong Kyun
authors.initials: BK
authors.lastname: Kang
authors.forename: Jae Hak
authors.initials: JH
authors.lastname: Kim
authors.forename: Moon-Soo
authors.initials: MS
authors.lastname: Koh
authors.forename: Chang-Hun
authors.initials: CH
authors.lastname: Yang
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000628:therapy*; D042883:Choledocholithiasis / Q000150:complications / Q000628:therapy*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies