The Study On The Effect Of Endoscopic Nasobiliary Drainage (ENBD) And Endoscopic Retrograde Biliary Drainage (ERBD) On Obstructive Jaundice

Objective To compare the effect of endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage(ERBD) on intestinal mucosal barrier function of patients with obstructive jaundice in clinical practice.Methods 40 patients with significant jaundice due to obstructive disorders of biliary tract and 20 health volunteers as controls were recruited.At the baseline,serum diamine oxidase(DAO) was measured by using ultraviolet spectrophotometer,while endotoxin and tumor necrosis factor-α(TNF-α) were determined by using endotoxin detector and ELISA kits,respectively.40 patients were then randomly divided into ENBD or ERBD group.Each has 20 patients.Dynamic changes in serum DAO,endotoxin and TNF-αwere observed postoperatively.Results In the patients with obstruction of biliary tract,higher serum bilirubin,γ-glutamyl transpeptidas(γ-GT),alkaline phosphatase(ALP), DAO,endotoxin and TNF-αwere found preoperatively as compared with those in health control(P＜0.05).After operation,both ERBD and ENBD have comparable effect on improving serum bilirubin,γ-GT and ALP,while serum DAO,endotoxin and TNF-αin each group were dramatically decreased.In day 1 after operation,there was no significant difference in serum DAO,endotoxin and TNF-αbetween two groups, but in day 3 and 7 after operation,serum DAO,endotoxin and TNF-αin ENBD group were significantly higher than those in ERBD group (P＜0.05).Conclusions It was indicated that both ERBD and ENBD have comparable effects on removing obstruction of biliary tract and draining bile.However,ERBD may have greater benefits than ENBD in improving intestinal mucosal barrier function,and thus would be more beneficial in preventing systemic inflammatory response.