内視鏡的胆道ドレナージ法における新しい試み　　ＥＲＢＤ‐ＥＮＢＤ併用法

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タイトル別名
  • New trial of endoscopic biliary drainage. A combined method of endoscopic retrograde biliary drainage(ERBD) and endoscopic naso-biliary drainage(ENBD).
  • -A COMBINED METHOD OF ENDOSCOPIC RETROGRADE BILIARY DRAINAGE (ERBD)AND ENDOSCOPIC NASO-BILIARY DRAINAGE (ENBD)-
  • ―ERBD-ENBD併用法―

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説明

Recently, endoscopic retrograde biliary drainage (ERBD) has become to be a common technique to relieve obstructive jaundice because of physiological one-step biliary decompression method. But ERBD has some demerits compared with external biliary drainage, such as percutaneous transhepatic biliary drainage (PTBD) and endoscopic naso-biliary drainage (ENBD). So we tried a new method, a combined method of ERBD and ENBD (ERBD+ENBD), in 13 patients with obstructive jaundice, and we performed successfully in all of the cases (Figure 1 describes the technique). Table 1 shows diseases we treated with ERBD and ERBD+ENBD. ERBD+ENBD established equivalent drainage effects (Table 2) and decreased serum bilirubin values after biliary decompression (Figure 2) compared with ERBD. In addition to those, we thought ERBD+ENBD is better than ERBD in three points ; (1) we can wash ERBD tube periodically without fiberscope, (2) we can investigate cytology and bacteriologic examination in bile juice frequently, and (3) we can get good X-ray pictures of dilated bile ducts when we needed. Complications were happened in 2 cases, one was falling off of ENBD tube, the other was bending of ENBD tube. In the cases, patients had no severe symptoms by pulling out ENBD tube. In conclusion, ERBD+ENBD will return to ERBD by simple procedure, namely, pulling out ENBD tube. Therefore, ERBD +ENBD is thought to be a improved technique remaining the merits of ERBD.

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