[Suprapapillary instead of transpapillary bile duct drainage in proximal bile duct obstructions]

The transpapillary passage of a catheter for internal biliary drainage may produce complications due to reflux or acute pancreatitis. A review of 573 biliary obstructions due to malignant tumours showed that in half the obstruction lay in the proximal two-thirds of the biliary passages. Fibrous strictures are nearly always in this region. In these patients, suprapapillary instead of transpapillary internal biliary drainage can be used, thereby maintaining the physiological relationship in the papilla. For this purpose we use a specially designed catheter which meets the requirements of suprapapillary internal drainage.