Comparison Between Endoscopic Biliary Stenting and Nasobiliary Drainage in Patients with Acute Cholangitis due to Choledocholithiasis: Is Endoscopic Biliary Stenting Useful?

BACKGROUND/AIMS: To clarify whether or not use of an endoscopic biliary stenting (EBS) is superior to endoscopic nasobiliary drainage (ENBD) in cases of acute cholangitis due to choledocholithiasis.

METHODOLOGY: Of 447 patients with choledocholithiasis who were treated in the Department of Gastroenterology, Fukuoka University Chikushi Hospital between January 1994 and September 2006, the subjects were 99 moderate acute cholangitis patients who underwent endoscopic drainage as initial treatment. Clinical efficacy, complications and patient satisfaction (meal intake rete) were investigated in the EBS group (67 patients) and the ENBD group (32 patients).

RESULTS: There were no significant differences in the improvement in inflammation, total bilirubin, or biliary enzymes between the EBS and ENBD groups. Catheter occlusion was seen in three patients (4%) in the EBS group, and the catheter was self-extracted by three patients (10%) in the ENBD group.

CONCLUSION: In moderate acute cholangitis due to choledocholithisis, the treatment efficacy and safety of EBS are equal to those of ENBD, and EBS appears to be a better choice in elderly patients in particular.