title: Endoscopic nasobiliary drainage for obstructive jaundice using either a 5 Fr or 7 Fr catheter: a prospective, randomized trial.
abstract: BACKGROUND
  The influence of size on the effectiveness of nasobiliary catheters has not yet been studied. We compared biliary drainage effectiveness and procedure-related discomfort and adverse events in 5 French (Fr) and 7 Fr nasobiliary catheters.
  
  
  METHODS
  We prospectively studied 100 patients undergoing endoscopic biliary drainage for obstructive jaundice, who were randomly allocated to a 5 Fr or 7 Fr nasobiliary catheter group. As the primary endpoint, the effectiveness was evaluated by the serum total bilirubin decreasing rate and the success rate of jaundice relief. As the secondary endpoint, the degree of discomfort was investigated using a questionnaire survey after catheter removal.
  
  
  RESULTS
  The bilirubin decrease rate was significantly higher in the 7 Fr catheter group than in the 5 Fr group (53.0 ± 21.4% vs 40.5 ± 29.9%, respectively; P = 0.019). The success rate of jaundice relief tended to be higher in the 7 Fr catheter group, although the difference was not statistically significant (98% vs 88%, respectively; P = 0.056). The questionnaire survey demonstrated that total discomfort was significantly greater in the 7 Fr group (3.9 ± 1.5 vs 3.2 ± 1.4, respectively; P = 0.018). Larger-diameter catheters tended to increase difficulty in eating, although the difference between the groups was not statistically significant.
  
  
  CONCLUSIONS
  7 Fr nasobiliary catheters are recommended for patients requiring rapid and reliable relief of obstructive jaundice. However, because they can cause greater discomfort, 5 Fr nasobiliary catheters are preferred in other settings.
  
  
  BACKGROUND
  On July 1, 2012; UMIN000008288 (Japan Primary Registries Network).
authors.affiliation: Department of Gastroenterology, NTT Medical Centre Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa, Tokyo 141-8625, Japan. toshio.fujisawa@east.ntt.co.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Fujisawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Kagawa
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Watanabe
authors.forename: Kantaro
authors.initials: K
authors.lastname: Hisatomi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Hajime
authors.initials: H
authors.lastname: Sato
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
mesh_terms: D000368:Aged; D057785:Catheters; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D004106:Dilatation / Q000379:methods; D004322:Drainage / Q000295:instrumentation* / Q000379:methods; D004724:Endoscopy; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000601:surgery*; D008297:Male; D015607:Stents; D016896:Treatment Outcome