A novel syringe tube combined guide-wire technique for repositioning a nasobiliary catheter in endoscopic nasobiliary drainage

Background: In endoscopic nasobiliary drainage (ENBD), it is complicated to reposition the catheter from the mouth to nostril. We developed a new technique using an 1-mL syringe tube combined with guide- wire when repositioning an ENBD tube from mouth to nose. The aim of this study was to verify its utility. Methods: A single-center, prospective, randomized, controlled study was conducted between January 2021 and December 2022. Compared to traditional guide-wire technique, the new technique added a 1mL syringe tube readily available in clinical work. The primary outcome was the ENBD repositioning time.The secondary outcomes included number of ENBD repositioning operations and technical success rate. Results: A total of 253 patients who underwent ENBD during the study period. Among them, 241 patients were enrolled in this study. The procedure time was significantly shorter in the new technique group than in the conventional group (60.7 vs. 98.7, p < 0.001). The median number of operations was 2 in both new technique and conventional technique groups(p = 0.36). Technical success was achieved in 95.0 %(113/119) of the new technique group and 98.4 % (120/122) of the conventional technique group(p = 0.14). Multiple linear regression analysis demonstrated that the new technique group (B = 36.9, 95%CI: 21.6 to 52.3, p < 0.001) was independent factor that reduce the ENBD repositioning time. Conclusions: The 1-mL syringe tube combined guide-wire technique for repositioning ENBD tube could improve the efficiency and shorten the procedure time than the guide-wire technique. Meanwhile, It is easy to obtain for popularization and application. (c) 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).