The Safety And Effectiveness Of Immediate Endoscopic Retrograde Cholangiopancreatography With Stone Extraction In Actue Obstructive Cholangitis

Objective:Endoscopic nasobiliary drainage(ENBD)with an nasobiliary catheter suggested be as effective as Endoscopic retrograde biliary drainage(ERBD)for temporary biliary drainage in acute obstructive cholangitis.However,there are few studies that have compared ENBD with stone extraction and ENBD only.We therefore compared the safety and effectiveness of Endoscopic biliary decompression by nasobiliary combine with stone extraction versus emergency endoscopic nasobiliary drainage then elective EST to extract stone.Method:A total of 241 screened patients with acute obstructive cholangitis were randomised to undergo emergency endoscopic biliary with ENBD combined with stone extraction(A,n=133,F=64,M=69)or ENBD only then elective EST to extract stone(B,n=108,F=52,M=56);Clinical outcomes such as length of stay,hospitalization costs,improvement of liver function and aderse events between the two group were compared.Result:Patient backgrounds were similar in the two group.Endoscopic biliary drainage was successfully achieved in all patients.The length of hospital stay was shorter in Group A than Group B,as well as the hospitalization costs(p<0.05);There was no statistical significance in the terms of the adverse event rate between the two groups(p>0.05);Both of the two groups got a significant improvement of liver function after ERCP.Conclusion:Emergency Endoscopic biliary decompression is an effective treatment for patients with acute obstructive cholangitis,withen a method of minimally invasive.Endoscopic biliary decompression by nasobiliary combine with stone extraction at once time can shorten the length of stay,decrease the hospital cost butwithout increase the postoperative complications.