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
