Duodenal Biliary Drainage
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What is duodenal biliary drainage?
Duodenal biliary drainage is a little-used procedure that sometimes can be helpful in diagnosing gallstones.
How is duodenal biliary drainage done?
For duodenal biliary drainage, a thin plastic or rubber tube with several holes at its tip is passed through a patient's anesthetized nostril, down the back of the throat, through the esophagus and stomach, and into the duodenum where the bile and pancreatic ducts enter the small intestine. This is accomplished with the help of fluoroscopy, a type of X-ray. Once the tube is in place, a synthetic hormone related to cholecystokinin is injected intravenously. The hormone causes the gallbladder to contract and squeeze out its concentrated bile into the duodenum. The bile then is sucked up through the tube and examined for the presence of cholesterol and pigment particles under a microscope.
A modification of duodenal biliary drainage involves collection of bile through an endoscope at the time of an upper gastrointestinal endoscopy - either by EGD (esophagogastroduodenoscopy) or by ERCP (endoscopic retrograde cholangio-pancreatography).
Get the latest treatment options.