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World J Gastrointest Endosc. Feb 16, 2010; 2(2): 50-53
Published online Feb 16, 2010. doi: 10.4253/wjge.v2.i2.50
Transnasal endoscopic biliary drainage as a rescue management for the treatment of acute cholangitis
Takao Itoi, Atushi Sofuni, Fumihide Itokawa, Takayoshi Tsuchiya, Toshio Kurihara, Kentaro Ishii, Shujiro Tsuji, Nobuhito Ikeuchi, Fuminori Moriyasu
Takao Itoi, Atushi Sofuni, Fumihide Itokawa, Takayoshi Tsuchiya, Toshio Kurihara, Kentaro Ishii, Shujiro Tsuji, Nobuhito Ikeuchi, Fuminori Moriyasu, Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan
Author contributions: Itoi T, Sofuni A, Itokawa F, Tsuchiya T, Kurihara T, Ishii K, Tsuji S, Ikeuchi N and Moriyasu F contributed to this paper.
Correspondence to: Takao Itoi, MD, PhD, Department of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Nishishinjuku 6-7-1, Tokyo 160-0023, Japan. itoi@tokyo-med.ac.jp
Telephone: +81-3-33426111 Fax: +81-3-53816654
Received: March 18, 2009
Revised: September 2, 2009
Accepted: September 9, 2009
Published online: February 16, 2010
Abstract

Endoscopic biliary drainage has been established to provide effective treatment for acute obstructive jaundice and cholangitis. A recently developed ultrathin transnasal videoendoscope (TNE) is minimally invasive even for critically ill patients and can be performed without conscious sedation. Transnasal endoscopic biliary drainage (TNE-BD) is performed using a front-viewing TNE with approximately 5 mm outer diameter and 2 mm working channel diameter. Finally, 5F naso-biliary tube or plastic stent are placed. Technical success rates are approximately 100% and 70% for post-endoscopic sphincterotomy or placement of self-expandable metallic stent, and intact papilla, respectively. There are no serious complications. In conclusion, although further cases should be accumulated, TNE-BD and in particular, one-step naso-biliary drainage using TNE may be a useful and novel technique for the treatment of acute cholangitis.

Keywords: Transnasal endoscope; Ultrathin endoscope; Biliary drainage