| Initial experience of transnasal endoscopic biliary drainage without conscious sedation for the treatment of acute cholangitis (with video). | |
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MedLine Citation:
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PMID: 18226697 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Endoscopic biliary drainage has been established as providing effective treatment for acute obstructive jaundice and cholangitis. A recently developed ultrathin transnasal videoendoscope is less invasive, even for patients who were critically ill, and can be performed without conscious sedation. OBJECTIVE: To evaluate the clinical efficacy and safety of biliary drainage (BD) by using transnasal videoendoscopy (TNE) without conscious sedation. DESIGN: Case series. SETTING: This procedure was performed at Tokyo Medical University Hospital. PATIENTS: Three patients with bile-duct stones and acute cholangitis and with a previous biliary endoscopic sphincterotomy (ES) were included in this study. INTERVENTION: All patients underwent BD by using a front-viewing TNE. Two 5F stents were placed into the bile duct across the major papilla. MAIN OUTCOME MEASUREMENT: The efficacy and safety of the TNE technique. RESULTS: Transnasal insertion of a TNE endoscope was feasible in all patients, without epistaxis. TNE BD was achieved in all patients. Abdominal pain, fever, and jaundice improved 24 hours after the procedure in all patients. Despite the absence of intravenous conscious sedation, all patients would agree to undergo the procedure again, if necessary. LIMITATIONS: Maneuverability of the TNE endoscope; limited to patients with a previous ES. CONCLUSIONS: In this small series, unsedated TNE can be used to successfully drain the biliary system in patients with a previous ES. Additional studies to validate this hypothesis are needed. |
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Authors:
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Takao Itoi; Takashi Kawai; Fumihide Itokawa; Atushi Sofuni; Toshio Kurihara; Takayoshi Tsuchiya; Kentaro Ishii; Shujiro Tsuji; Nobuhito Ikeuchi; Mami Takeuchi; Yoshihiro Sakai; Fuminori Moriyasu |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 67 ISSN: 0016-5107 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2008 Feb |
Date Detail:
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Created Date: 2008-01-29 Completed Date: 2008-04-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 328-32 Citation Subset: IM |
Affiliation:
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Department Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Cholangitis / etiology, surgery* Conscious Sedation Drainage / methods* Endoscopy, Gastrointestinal* Gallstones / complications Humans Male Stents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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