Endoscopic nasobiliary drainage

Endoscopic nasobiliary drainage is a common method for treating liver and gallbladder diseases. It is also the most commonly used endoscopic biliary drainage technique. It is a relatively thin plastic tube that, under the guidance of an endoscope, enters the duodenum and the bile duct to establish a way for extracorporeal drainage of bile. This is a better way to solve bile duct obstruction. It is relatively simple to treat and safe to operate.

Operation method 1. Instrument preparation: therapeutic duodenoscope (biopsy channel diameter is above 2.8mm), guide wire [0.89-0.97mm (0.035-0.038in), about 4m long], nasobiliary ducts of various specifications. All instruments used should be strictly sterilized. 2. Perform ERCP routinely to understand the nature and location of the lesion and determine the necessity of ENBD and its drainage site. 3. Insert a guide wire through the angiography catheter and superselect the bile duct that needs drainage. 4. Remove the catheter, leave a guide wire in place, and then gradually insert the guide wire into the nasobiliary duct to the drainage site. 5. Under fluoroscopy, insert the tube and withdraw the endoscope to lead the nasobiliary duct out of the mouth. 6. A catheter is inserted into the nose and removed from the mouth. The nasobiliary duct is guided out of the nostril with the help of this catheter and properly fixed.

Indications 1. Acute suppurative obstructive cholangitis; 2. Prevent stone impaction and bile duct infection after ERCP or lithotripsy; 3. Biliary obstruction caused by primary or metastatic benign or malignant tumors; 4. Biliary obstruction caused by hepatobiliary stones; 5. Acute biliary pancreatitis;6. Traumatic or iatrogenic bile duct stenosis or bile fistula; 7. Clinically, it is necessary to repeat cholangiography or collect bile for biochemical and bacteriological examination; 8. Bile duct stones require drug perfusion for lithotripsy; sclerosing cholangitis requires drug perfusion for treatment; intracavitary chemotherapy for cholangiocarcinoma, etc.