Surgical Endoscopy

, Volume 1, Issue 3, pp 147–150 | Cite as

Nasobiliary drainage following endoscopic sphincterotomy

A useful method of preventing and treating early complications
  • E. Ricci
  • R. Conigliaro
  • G. Bertoni
  • M. G. Mortilla
  • G. Bedogni
  • S. Contini
Original Articles

Summary

The authors analyze a retrospective study of 850 patients who underwent endoscopic sphincterotomy (ES). One group of patients (705) routinely had nasobiliary drainage following ES as a prophylactic measure to prevent complications, while 145 patients were not drained. Complications, mortality and the need for emergency surgery were compared in both groups. In the drained group, the complication rate was 2% vs 10.3% in the nondrained group (P<0.001), and mortality was 0.4% vs 2.7% (P=0.03). Emergency surgery was required in 0.1% in the drained patients versus 3.4% in the nondrained group (P=0.01). Based on these data within the limits of a retrospective study, the authors strongly support the routine use of nasobiliary drainage to prevent complications, which usually occur within the first 24 h, and also to facilitate the immediate treatment of the complications. This procedure is also highly recommended when ES is performed by inexperienced endoscopists and with a technically demanding ES, which is frequently followed by complications.

Key words

Endoscopic sphincterotomy Papillary stenosis Choledocholithiasis Nasobiliary drainage Paravaterian diverticula Cholangitis Pancreatitis 
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References

  1. 1.
    Bedogni G, Bertoni G, Contini S, Fabbian F, Pedrazzoli C, Ricci E (1984) Endoscopic sphincterotomy in patients with Billroth II partial gastrectomy: comparison of three different techniques. Gastrointest Endosc 30: 300–304Google Scholar
  2. 2.
    Bedogni G, Oselladore D, Ricci E, Rossoni R (1984) Operative endoscopy of the digestive tract. Ishiyaku Euro America, New York, pp 107–163Google Scholar
  3. 3.
    Bedogni G, Contini S, Ricci E, Pedrazzoli C, Rossi G, Serafini G (1985) Il trattamento mediante papillosfinterotomia endoscopica della calcolosi residua e recidiva del coledoco: risultati di 180 casi. Minerva Dietol Gastroenterol 31: 475–476Google Scholar
  4. 4.
    Bedogni G, Meinero M, Barbieri I, Ricci E, Bigi L, Pedrazzoli C, Contini S, Bertoni G, Conigliaro R, Rossi G (1986) Foreign bodies of the biliary tract. Endoscopic management. Dig Dis Sci 31: 1100–1104Google Scholar
  5. 5.
    Classen M, Hagenmüller F (1984) Endoscopic biliary drainage. Scand J Gastroenterol 120: 76–83Google Scholar
  6. 6.
    Classen M, Wurbs D, Hagenmüller F (1978) Complication of endoscopic papillotomy. In: Demling L, Classen M (eds) Endoscopic sphincterotomy of the papilla of Vater. Thieme, Stuttgart, pp 59–62Google Scholar
  7. 7.
    Classen M, Lauschner U, Schreiber HW (1983) Clinics in gastroenterology. Biliary tract diseases. Saunders, Philadelphia, pp 247–281Google Scholar
  8. 8.
    Cotton PB, Vallon AG (1981) British experience with duodenoscopic sphincterotomy for removal of bile duct stone. Br J Surg 68: 373–376Google Scholar
  9. 9.
    Cotton PB, Burney PGJ, Mason RR (1979) Transnasal bile duct catheterisation after endoscopic sphincterotomy. Gut 20: 285–287Google Scholar
  10. 10.
    Dunham F, Bourceois N, Gelin M, Jeanmart J, Toussaint J, Cremer M (1982) Retroperitoneal perforations following endoscopic sphincterotomy: clinical course and management. Endoscopy 14: 92–96Google Scholar
  11. 11.
    Hagenmüller F, Classen M (1982) Therapeutic endoscopic and percutaneous procedures for biliary disorders. In: Popper H, Shuffuer F (eds) Progress in liver diseases. Grune & Stratton, New York London, pp 299–318Google Scholar
  12. 12.
    Houghton PWJ, Jenkinson LR, Donaldson LA (1985) Cholecystectomy in the elderly: prospective study. Br J Surg 72: 220–222Google Scholar
  13. 13.
    Kawai K, Nakajima M (1983) Present status and complications of EST in Japan. Endoscopy 15: 169–172Google Scholar
  14. 14.
    Leese T, Neoptolemos JP, Carr-Locke DL (1985) Success, failures, early complications and their management following endoscopic sphincterotomy: results in 392 consecutive patients from a single centre. Br J Surg 72: 215–219Google Scholar
  15. 15.
    Mazzeo RJ, Jordan FT, Strasius SR (1983) Endoscopic papillotomy for recurrent common bile duct stones and papillary stenosis. Arch Surg 118: 693–696Google Scholar
  16. 16.
    Montori A, Buccino RV, Ciolfi F, Masi V (1985) Surgical treatment of the endoscopic sphincterotomy (ES) complications. Acta Endosc 15: 1–97 (abstr)Google Scholar
  17. 17.
    Nashaus B, Safrany L (1981) Complications of endoscopic sphincterotomy and their treatment. Endoscopy 13: 197–199Google Scholar
  18. 18.
    Passi RD, Raval B (1982) Endoscopic papillotomy. Surgery 92: 581–588Google Scholar
  19. 19.
    Safrany L, Cotton PB (1982) Endoscopic management of choledocholithiasis. Surg Clin North Am 62: 825–836Google Scholar
  20. 20.
    Sullivan DM, Hood TR, Griffen WO (1982) Biliary tract surgery in the elderly. Arch Surg 143: 218–220Google Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • E. Ricci
    • 1
  • R. Conigliaro
    • 1
  • G. Bertoni
    • 1
  • M. G. Mortilla
    • 1
  • G. Bedogni
    • 1
  • S. Contini
    • 2
  1. 1.Second Department of Surgery, Division of Surgical EndoscopyArcispedale S. Maria NuovaReggio EmiliaItaly
  2. 2.Institute of Surgical PathologyUniversity of ParmaParmaItaly

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