Endoscopic Nasobiliary Drainage

1. Acute suppurative obstructive cholangitis, which is used as a decompression drainage for cholangitis, can also be used to prevent the occurrence of cholangitis after ERCP. 2. Biliary obstruction caused by primary or secondary tumors. 3. Bile duct obstruction caused by hepatolithiasis is also used to prevent incarceration of common bile duct stones. 4. Biliary pancreatitis. 5. Benign stricture of the bile duct. 6. Traumatic or iatrogenic biliary fistula. 7. Sclerosing cholangitis can be perfused with drugs such as steroids at the same time as bile duct drainage. 8. Other uses, such as cholelithiasis treatment, extracorporeal shock wave lithotripsy (ESWL), intracavitary radiotherapy for cholangiocarcinoma, and hepatobiliary function tests. Treatment of diseases: acute obstructive suppurative cholangitis, acute biliary pancreatitis Indication 1. Acute suppurative obstructive cholangitis, which is used as a decompression drainage for cholangitis, can also be used to prevent the occurrence of cholangitis after ERCP. 2. Biliary obstruction caused by primary or secondary tumors. 3. Bile duct obstruction caused by hepatolithiasis is also used to prevent incarceration of common bile duct stones. 4. Biliary pancreatitis. 5. Benign stricture of the bile duct. 6. Traumatic or iatrogenic biliary fistula. 7. Sclerosing cholangitis can be perfused with drugs such as steroids at the same time as bile duct drainage. 8. Other uses, such as cholelithiasis treatment, extracorporeal shock wave lithotripsy (ESWL), intracavitary radiotherapy for cholangiocarcinoma, and hepatobiliary function tests. Contraindications 1. Have an ERCP contraindication. 2. Patients with severe esophageal varices and bleeding tendency. Preoperative preparation 1. The instrument is prepared for the treatment of duodenoscopy (the diameter of the biopsy hole is 2.8mm or more), the guiding wire [0.89-0.97mm (0.035-0.038in), the length is about 4m], and the nasal bile duct of various specifications (according to the front end) Different shapes are suitable for placement in the left hepatic duct, right hepatic duct, and common bile duct), and the instruments used should be strictly sterilized. 2. The patient is prepared to have the same general ERCP and should be given a sufficient amount of broad-spectrum antibiotics and vitamin K. Surgical procedure 1. Regular ERCP diagnosis, to understand the nature of the lesion and its location, to determine the necessity of ENBD and its drainage site. 2. Insert the guide wire through the contrast catheter and over-select to the bile duct to be drained. 3. Exit the catheter, indwell the guide wire, and then gradually feed the nasal canal into the drainage site through the guide wire. 4. Exit the endoscope while intubating under the fluoroscopy, and pull the nasal bile duct out of the mouth. 5. Insert a catheter into the nose and remove it from the mouth. With the guidance of this catheter, the nasal bile duct is taken out of the nostril and properly fixed.

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