A comparative study of 4 Fr versus 6 Fr nasobiliary drainage catheters: A randomized, controlled trial

作者：Ishigaki Takashi^*; Sasaki Tamito; Serikawa Masahiro; Minami Tomoyuki; Okazaki Akihito; Yukutake Masanobu; Ishii Yasutaka; Kosaka Keiichi; Mouri Teruo; Yoshimi Satoshi; Chayama Kazuaki

来源：Journal of Gastroenterology and Hepatology, 2014, 29(3): 653-659.

DOI：10.1111/jgh.12427

• endoscopic retrograde cholangiopancreatography
• post-endoscopic retrograde cholangiopancreatography pancreatitis
• visual analog scale

Background and AimDespite the benefits of endoscopic nasobiliary drainage (NBD) in endoscopic retrograde cholangiopancreatography (ERCP), post-ERCP pancreatitis (PEP) and nose/throat discomfort can result. We aimed to determine whether the use of a smaller catheter alleviates these complications. %26lt;br%26gt;MethodA randomized, controlled trial at a tertiary care center compared 4 Fr and 6 Fr NBD catheters; 165 ERCP patients with naive papillae were randomly assigned to a catheter-size group. %26lt;br%26gt;ResultsThe prevalence of PEP was significantly lower in the 4 Fr group (3.7%; 3/82) than in the 6 Fr group (15.7%; 13/83; P=0.019). No spontaneous catheter displacement occurred within 24h. Discomfort visual analog scores were 2.6 and 4.3 in the 4 Fr and 6 Fr groups, respectively (P=0.0048) on procedure day; on the following day, the scores were 2.3 and 3.6 (P=0.028). Bile output was 16.3mL/h and 21.4mL/h in the 4 Fr and 6 Fr groups (P=0.051). On obstructive jaundice subgroup analysis, bile drainage was 19.2mL/h and 22.1mL/h in the 4 Fr and 6 Fr groups (P=0.40). The 4 Fr group required 5.6 days to reduce bilirubin levels versus 6.1 days in the 6 Fr group (P=0.51). %26lt;br%26gt;ConclusionsIn patients with naive papillae, lower rates of PEP and less nose/throat discomfort are associated with the use of 4 Fr NBD catheters. In patients with obstructive jaundice, 4 Fr and 6 Fr catheters are comparable with regard to bile output and bilirubin level reduction.

• 出版日期2014-3