Preverntion Of Post Therapeutic ERCP Pancreatitis And Hyperamylasemia With Endoscopic Nosal Biliary Drainage

Objective:To assess the value of endoscopic nasol biliary drainage (ENBD)to prevent post therapeutic ERCP pancreatitis and hyperamylasemia. Methods:A series of 140patients in high risk of acute pancreatitis and hyperamylasemia after therapeutic ERCP were divided into two groups. 54patients underwent ENBD after ERCP,papillosphincterotomy and basket lithotripsy. The mean amylase lever at 2hr and 24hr after therapeutic ERCP were measured. Meanwhile the occuring of acute pancreatitis and hyperamylasemia were also observed. Results:The mean amylase lever at 2hr of the drainage group was 1 70.68 + 1 1 6. 45,significantly higher than that in the controls. ( 275.84 +333.1 1,P<0. 05). Hyperamylasemia occurred in 9.26% of patients in drainage group compared with 26.74% of patients in non-drainage group .( PO.05) Acute pancreatitis was clinically established in 6.98% of patients in non-drainage group with significance ( P<0.05)when compared with the drainage group(0%). There were significant differences in the mean amylase lever at 2h and the incidence of acute pancreatitis and hyperamylasemia. The mean amylase lever at 24hr of the drainage group was 234.47 + 437. 08,no difference with that in the controls (349.49 +504.52,P>0.05).Conc1usions:ENBD can decrease the pressure within the biliary and pancreatic duct effectively and alleviate the development of pancreatitis. It is considered that ENBD is a practiseof choice for selected to prevent post therapeutic ERCP pancreatitis and hyperamylasemia.