Background: Acute suppurative cholangitis is associated with significant mortality. It is best managed by drainage of the biliary tree, endoscopic, percutaneous or surgical.
Aims: To study the effect of emergency endoscopic nasobiliary drainage (ENBD) in acute suppurative calculous cholangitis.
Methods: In 37 patients with calculous cholangitis, an endoscopic nasobiliary drain (7 F) was placed in the biliary tree above the site of obstruction to ensure continuous biliary drainage.
Results: Success rate was 100% and there was no mortality. ENBD was performed in 4 very sick patients without the aid of fluoroscopy. Cholangitis improved in 36 of 37 patients within 12-24 hours. When the clinical condition improved, all the 36 patients were taken up for elective biliary surgery or endoscopic sphincterotomy and stone extraction.
Conclusions: Emergency endoscopic nasobiliary drainage is an effective method in managing patients with acute suppurative calculous cholangitis.