Clinical effect of endoscopic nasobiliary drainage in prevention of post- ERCP pancreatitis in patients with choledocholithiasis

Objective To investigate the clinical effect of endoscopic nasobiliary drainage (ENBD) in the prevention of post- endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and hyperamylasemia in patients with choledocholithiasis.Methods A total of 560 patients with choledocholithiasis who underwent ERCP from October 2010 to December 2013 were included in the study.ENBD was performed in 371 patients (test group) , and the other 189 patients were designated as control group.Serum amylase level was measured at 3 and 24 h after ERCP, and the incidence of PEP and hyperamylasemia was determined.Comparison of continuous data between the two groups was made by t test, while comparison of rates was made by chi- square test.Results The incidence rates of PEP and hyperamylasemia in the test group were 8.1% (30 /371) and 13.7% (51 /371) , respectively, significantly lower than those in the control group (13.8%, 26/189;21.2%, 40/189) , (χ2= 4.47, P = 0.034;χ2= 5.06, P = 0.024) .The serum amylase levels at 3 and 24 h after ERCP in the test group were 215.34 ± 304.00 U /L and 199.38 ± 273.32 U /L, respectively, significantly lower those in the control group (283.28 ±261.76 U/L and 257.05 ±199.25 U/L) (t =2.61, P =0.01;t =2.57, P =0.01) .Conclusion ENBD can effectively reduce the incidence of PEP and hyperamylasemia in patients with choledocholithiasis.