Drainage Effect on Endoscopic Retrograde Biliary Drainage (ERBD) Y Tanaka 1 , M. Nskajima 2 , S. Fujimoto 2 , K. Yamaguchi 6 1Department of Priventive Medicine, Kyoto Prefectural University of Medicine pp.1205-1212
Published Date 1982/11/25
DOI https://doi.org/10.11477/mf.1403108698
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 Between October 1981 and July 1982 the introduction of ERBD tube (18 pig tail catheter and two large bore tube with side flaps) was successful in 20 out of 26 patients (76.9%) with obstructive jaundice,14 males,6 females, mean age 62.0 (range 38~76). In 15 patients the biliary obstruction was due to malignancy (6 pancreatic cancers,6 biliary cancers,3 metastatic liver tumors) and in 5 patients due to benign disease (2 choledocholithiasis with cholangitis,2 choledocholithiasis with cholecystolithiasis,1 benign papillary tumor). In 4 out of 15 patients with malignant disease the surgical operation was performed in four weeks after ERBD and 2 patients died in the first month after the insertion of the endoprosthesis. Nine patients are still living more than one month after ERBD. The average time interval is 11.7 weeks (range 4~28). In 6 secondary ERBD cases the ERBD was performed after the relief of jaundice by PTCD, in 14 primary ERBD cases only the insertion of ERBD tube were performed due to relieve jaundice. Complications were 5 cases, one perforation of duodenal wall with pig tail ERBD tube, one dislodgement and 2 cloggings of drainage tube by blood and bile and one case of cholangitis after the insertion of the endoprosthesis.

 On the drainage effect 14 primary ERBD cases were compared with 32 PTCD cases without liver metastasis. No significant difference can be statistically detected in serum bilirubin level before biliary drainage between 11.6±7.8 mg/dl (mean±S) in primary ERBD cases and 16.6±10.6 mg/dl in PTCD cases. The percentage of the cases with under 5 mg/dl in serum bilirubin level two weeks after biliary drainage was 78.6 in primary ERBD and 56.2 in PTCD, no significant difference could be found. On the other hand, the decreasing rates expressed the percentage of the bilirubin level after biliary drainage against the level before drainage were significantly lower in primary ERBD cases than those of PTCD at two weeks (p<0.005) and four weeks (p<0.01) after biliary drainage. It was concluded from these results that ERBD was effective biliary drainage same as PTCD and could be used as a permanent safety drainage.

Copyright © 1982, Igaku-Shoin Ltd. All rights reserved.


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