25741153
OBJECTIVE	To evaluate the necessity of endoscopic nasobiliary drainage ( ENBD ) catheter placement after clearance of common bile duct ( CBD ) stones .
METHODS	Patients enrolled in this study were randomly divided into two groups , according to whether or not they received ENBD after the removal of CBD stones .
METHODS	Group 1 ( ENBD group ) was then subdivided into three groups : G1a patients received an endoscopic papillary balloon dilatation ( EPBD ) , G1b patients received an endoscopic sphincterotomy ( EST ) , and G1c patients received neither .
METHODS	Group 2 ( non-ENBD group ) patients were also subdivided into three groups ( G2a , G2b , and G2c ) , similar to Group 1 .
METHODS	The maximum CBD diameter , the time for C-reactive protein ( CRP ) to normalize , levels of serum amylase , total serum bilirubin ( TB ) and alanine aminotransferase ( ALT ) , and postoperative hospitalization duration ( PHD ) were measured .
RESULTS	A total of 218 patients ( 139 males , 79 females ) , with an average age of 60.110.8 years , were enrolled in this study .
RESULTS	One hundred and thirteen patients who received ENBD were included in Group 1 , and 105 patients who did not receive ENBD were included in Group 2 .
RESULTS	The baseline clinical characteristics were similar in both groups .
RESULTS	There were no significant differences in post-endoscopic retrograde cholangiopancreatography ( ERCP ) - related complications when Groups 1 and 2 were compared .
RESULTS	Seventy-seven patients underwent EPBD , and 41 received an ENBD tube ( G1a ) and 36 did not ( G2a ) .
RESULTS	Seventy-three patients underwent EST , and 34 patients received an ENBD tube ( G1b ) and 39 did not ( G2b ) .
RESULTS	The remaining 68 patients underwent neither EPBD nor EST ; of these patients , 38 received an ENBD tube ( G1c ) and 30 did not ( G2c ) .
RESULTS	For each of the three pairs of subgroups ( G1a vs G2a , G1b vs G2b , G1c vs G2c ) , there were no significant differences detected in the PHD or the time to normalization of CRP , TB and ALT .
RESULTS	In the EPBD group , the incidence of post-ERCP pancreatitis , hyperamylasemia and overall patient complications was significantly higher for G2a ( post-ERCP pancreatitis : 6/36 vs 0/41 , P = 0.0217 ; hyperamylasemia : 11/36 vs 4/41 , P = 0.0215 ; overall patient complications : 18/36 vs 7/41 , P = 0.0029 ) .
CONCLUSIONS	After successful CBD stone clearance , ENBD is only beneficial when an EPBD procedure has been performed .

