Endoscopic nasobiliary drainage is superior to biliary stent placement in preventing postendoscopic papillary balloon dilation pancreatitis

作者：Junlong Lin, Baifeng Qian, Zhichao Li, Jialin Chen, Kai Gao, Jianpeng Cai, Yunpeng Hua · 发表于：Therapeutic Advances in Gastroenterology · 年份：2025 · DOI：10.1177/17562848251365025 · 被引用次数：1 · 研究领域：Gallbladder and Bile Duct Disorders、Pancreatitis Pathology and Treatment、Pediatric Hepatobiliary Diseases and Treatments

Background: Endoscopic papillary balloon dilation (EPBD) has been recommended as a potential alternative to endoscopic sphincterotomy for common bile duct stones (CBDS), due to protecting the sphincter function. Objectives: This retrospective study aims to evaluate the safety and efficacy of endoscopic nasobiliary drainage (ENBD) versus endoscopic retrograde biliary drainage (ERBD) after EPBD for CBDS. Design: This study is a retrospective analysis of patients with CBDS who underwent EPBD followed by either ENBD or ERBD. It enrolled 283 patients, who underwent slow dilation and long-duration EPBD for CBDS with ENBD (eNbd group, n = 154) or ERBD (eRbd group, n = 129) from January 2022 to September 2023. Methods: Propensity score matching (PSM) was used to balance preoperative baselines and intraoperative specifics, resulting in 220 matched patients (110 patients per group). The incidence rate of post-ERCP pancreatitis (PEP) was compared between the two groups, and risk factors for PEP were analyzed. Results: After PSM, there were no significant differences in the baseline between the eNbd group and the eRbd group. The eNbd group exhibited significantly greater reduction in serum bilirubin levels compared to the eRbd group. Before PSM, the incidence rate of PEP was 2.6% (4/154) in the eNbd group and 8.5% (11/129) in the eRbd group ( p = 0.027). After PSM, the incidence rate of PEP was 2.7% (3/110) in the eNbd group and 9.1% (10/110) in the eRbd group ( p = 0.045). In addition, ...