Endoscopic Nasopancreatic and Nasobiliary Drainage (ENPD and ENBD)
Nasobiliary catheter provides drainage of the pancreaticobiliary system and facilitates interventional procedures, both for diagnostic and therapeutic purposes [1]. The following contents focus on the indications for drainage, the technique of insertion,
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Nasobiliary catheter provides drainage of the pancreaticobiliary system and facilitates interventional procedures, both for diagnostic and therapeutic purposes [1]. The following contents focus on the indications for drainage, the technique of insertion, and associated complications. Special issues on the management of biliary and pancreatic diseases will be also discussed. Keywords
Endoscopic nasopancreatic drainage • Pancreatic stent • Pancreatic stones Papillary stenosis • Traumatic pancreatic duct • Pancreatic juice cytology Pancreatic duct stricture • Pancreatic divisum • Pancreatic pseudocyst • Pancreatic ascites • Stent migration • Pancreatitis • Intraductal papillary mucinous neoplasm • Pancreatic cancer • Cholangitis • Endoscopic sphincterotomy • Biliary drainage • Endoscopic retrograde cholangiopancreatography • Ultrathin endoscope • Klatskin tumors • Biliary stenting • Nasobiliary drainage • Complication • Radiofrequency ablation • Hepatocellular carcinoma • Gangrenous cholecystitis
Introduction
C.-J. Chen, M.D. • C.-C. Lin, M.D. C.-H. Chu, M.D. (*) Department of General Medicine and Division of Gastroenterology, MacKay Memorial Hospital, Taipei, Taiwan e-mail: [email protected]
Nasobiliary catheter provides drainage of the pancreaticobiliary system and facilitates interventional procedures, both for diagnostic and therapeutic purposes [1]. The following contents focus on the indications for drainage, the technique of insertion, and associated complications. Special issues on the management of biliary and pancreatic diseases will be also discussed.
© Springer Nature Singapore Pte Ltd. 2018 K.-H. Lai et al. (eds.), Biliopancreatic Endoscopy, https://doi.org/10.1007/978-981-10-4367-3_6
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Endoscopic Nasopancreatic Drainage (ENPD) Indications of ENPD Nasopancreatic catheter is used for temporary endoscopic drainage of the pancreatic duct through the nasal passage by use of an indwelling catheter. ENPD may be an alternative to pancreatic stenting, and thus it shares the same indications of pancreatic stenting, such as to relieve ductal obstruction, no matter from strictures, stones, or papillary stenosis. For the traumatic pancreatic duct, pancreatic drainage tube can serve as a bridge of the disrupted portion [2]. ENPD is also useful to collect samples for pancreatic juice cytology and for treating leakage of pancreatic juice and occlusive pancreatitis [3].
The Technique of Insertion Procedure ENPD is an external drainage procedure by placing a 4 Fr to 5 Fr tube, made of polyethylene in the pancreatic duct [4]. There are many side holes along the proximal portion of the catheter. These side holes allow draining of pancreatic juice [5]. Some designs are with flaps, for the prevention of spontaneous migration (Fig. 1).
ENPD Procedure 1. A catheter (blue) is cannulated into the main pancreatic duct, and then a guidewire (red) is passed through the catheter into the main pancreatic duct (Fig. 2a).
2. The catheter is withdrawn, and then the ENPD tube (green) is passed
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