Open AccessTransnasal endoscopic biliary drainage as a rescue management for the treatment of acute cholangitis
Author(s) -
Takao Itoi,
Atushi Sofuni,
Fumihide Itokawa,
Takayoshi Tsuchiya,
Toshio Kurihara,
Kentaro Ishii,
Shujiro Tsuji,
Nobuhito Ikeuchi,
Fuminori Moriyasu
Publication year - 2010
Publication title -
world journal of gastrointestinal endoscopy
Language(s) - English
Resource type - Journals
ISSN - 1948-5190
DOI - 10.4253/wjge.v2.i2.50
Subject(s) - medicine , major duodenal papilla , biliary drainage , endoscopic retrograde cholangiopancreatography , stent , surgery , biliary stent , obstructive jaundice , sedation , drainage , endoscopic treatment , endoscopy , pancreatitis , ecology , biology
Endoscopic biliary drainage has been established to provide effective treatment for acute obstructive jaundice and cholangitis. A recently developed ultrathin transnasal videoendoscope (TNE) is minimally invasive even for critically ill patients and can be performed without conscious sedation. Transnasal endoscopic biliary drainage (TNE-BD) is performed using a front-viewing TNE with approximately 5 mm outer diameter and 2 mm working channel diameter. Finally, 5F naso-biliary tube or plastic stent are placed. Technical success rates are approximately 100% and 70% for post-endoscopic sphincterotomy or placement of self-expandable metallic stent, and intact papilla, respectively. There are no serious complications. In conclusion, although further cases should be accumulated, TNE-BD and in particular, one-step naso-biliary drainage using TNE may be a useful and novel technique for the treatment of acute cholangitis.