Nasobiliary drainage in acute cholestatic hepatitis with pruritus

Dig Liver Dis. 2009 Jun;41(6):442-5. doi: 10.1016/j.dld.2008.06.012. Epub 2008 Jul 25.

Abstract

Background/aim: Cholestatic acute viral hepatitis may have prolonged course. Pruritus is often a prominent feature and difficult to control. Sometimes it may be accompanied by severe cough. There are no reports of endoscopic nasobiliary drainage in these patients.

Methods: We prospectively evaluated the role of nasobiliary drainage in six patients with cholestatic acute viral hepatitis with intractable pruritus and accompanying severe cough in one patient in an uncontrolled study.

Results: There were five male and one female patient with cholestatic acute viral hepatitis with intractable pruritus. One patient also had severe cough. Nasobiliary drainage relieved pruritus in all patients and patient with cough also showed marked improvement within 24h. Nasobiliary drainage also hastened the recovery in these patients.

Conclusions: Short-term nasobiliary drainage should be considered in patients with cholestatic acute viral hepatitis with intractable pruritus and cough for symptomatic relief. It may help in faster recovery in these patients. However, a larger randomized controlled study is warranted.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Disease
  • Adult
  • Alkaline Phosphatase / blood
  • Bile Acids and Salts / blood
  • Bilirubin / blood
  • Cholestasis / blood
  • Cholestasis / complications*
  • Cholestasis / therapy*
  • Cough / therapy
  • Cough / virology
  • Drainage / methods*
  • Female
  • Hepatitis, Viral, Human / blood
  • Hepatitis, Viral, Human / complications*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Pruritus / blood
  • Pruritus / diagnosis
  • Pruritus / therapy*
  • Pruritus / virology*
  • Severity of Illness Index
  • Transaminases / blood
  • Treatment Outcome
  • Young Adult

Substances

  • Bile Acids and Salts
  • Transaminases
  • Alkaline Phosphatase
  • Bilirubin