Experiences with the Long Standing Nasobiliary Tube in Biliary Diseases

Summary

Specially designed longstanding nasobiliary tubes allow to reflect upon some well established therapeutic rules. The safe, decompressing effect of the tube leads to prompt relief of obstructive suppurative cholangitis. Therefore emergency of laparotomy can be avoided in high risk patients. Large common bile duct stones until now have required a large papillotomy with increased frequency of complications. The attempt to dissolve those stones with Capmul is justified on an account of a 50 % success rate. Either a very small EPT or even non is necessary in order to insert the tube.

The diagnostic and scientific aspects of this tube result from the possibility to get pure bile from the common duct at any time necessary. With this procedure, bacterial elimination kinetics under antibiotic therapy can be analyzed; 24-hour profile of bile lithogenicity may be examined and probably this technic can be of value for bile salt metabolism and kinetics.

Key words:

Nasobiliary tube - Gallstone dissolution - Suppurative cholangitis