Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction

Table 2 Procedures, adverse events, and causes of dysfunction in patients who underwent preoperative plastic stent and nasobiliary catheter placement n (%)

	All patients (n = 419)	PS (n = 253)	NBC (n = 166)	P value
Procedures of the initial ERCP
EST or EPBD	178 (43)	101 (40)	77 (46)	0.202
Biopsy or brushing of the bile duct	362 (86)	214 (85)	148 (89)	0.234
Positive for cancer	250 (60)	150 (59)	100 (60)
Biliary stents/catheters placed
Diameter 5-6/7-7.5/8.5-10 Fr	98/236/85 (23/56/20)	18/150/85 (7/59/34)	80/86/0 (48/52/0)	< 0.001
Pig-tailed tip/straight tip	152/2241	74/177 (29/71)	78/47 (62/38)	< 0.001
Placement of pancreatic stent	41 (10)	25 (10)	16 (10)	0.935
Adverse events (other than cholangitis)
Pancreatitis	40 (10)	26 (10)	14 (8)	0.612
Mild/moderate/severe	30/10/0
Cholecystitis	4 (1)	2 (1)	2 (1)	0.650
Others	4 (1)	2 (1)	2 (1)	0.650
Stent/catheter dysfunction	118 (36)	88 (35)	30 (18)	< 0.001
Causes of PS/NBC dysfunction
Occlusion or cholangitis	85	69 (27)	16 (10)	0.013
Insufficient drainage	19	14 (6)	5 (3)	0.330
Migration	10	5 (2)	5 (3)	0.526
Inadvertent removal	4	NA	4 (2)	NA
Number of ERCPs	2 (1-2)	1 (1-1)	2 (1-2)	< 0.0001

¹Data was not obtained in 43 patients. A part of data on tips of PS/NBC was missing. “Occlusion or cholangitis” included jaundice or re-elevation of liver enzyme with or without fever-up, and fever-up without other causes even if no elevation of liver enzyme; “Insufficient drainage” included persistent liver dysfunction or limited improvement of the elevated liver enzyme, which is sometimes difficult to distinguish from other causes of liver dysfunction. PS: Plastic stent; NBC: Nasobiliary catheter; ERCP: Endoscopic retrograde cholangiopancreatography; EST: Endoscopic sphincterotomy; EPBD: Endoscopic papillary balloon dilation; NA: Not applicable.