Efficacy of a Novel Adjustable Snare Technique Versus the Conventional Technique for Converting the Orobiliary Catheter to a Nasobiliary Catheter.

Background and object: It is a challenging step to guide a nasobiliary catheter from the mouth to the nasal cavity in endoscopic nasobiliary drainage (ENBD), and new methods are always being explored to improve the procedure. We have developed a novel device which is composed of a dedicated adjustable snare and a tongue depressor-like handle, for completing oral-nasal conversion of the ENBD tube. In this study, we aim to assess the utility of our new technique in repositioning the ENBD catheter by comparing it with conventional guidewire technique.

Method: The patients who underwent ENBD at Zhongnan Hospital of Wuhan University were enrolled to the study. They were randomly divided into the new and conventional technique groups. The primary outcome was the first-time success rate of operation. The secondary outcome included the procedure time, the comfortable degree, and adverse event rates.

Results: Compared with using the conventional technique, the first-time success rate of operation using the novel adjustable snare technique to replace the ENBD catheter from the mouth to the nostril was significantly improved (76.19% vs. 51.43%, p < 0.001). The procedure time was significantly shorter using the new device (78.96 s vs. 102.4 s, p < 0.001). In addition, the discomfort scores of patients in the new technique group were lower than those in the conventional group (p < 0.001).

Conclusion: Our novel adjustable snare technique improved the first-time success rate of the nasobiliary catheter repositioning, shortened the procedure time, and alleviated the patient's discomfort.

Trial registration: Chinese Clinical Trial Registry number: ChiCTR2400085838.