Duodenal Intubation by an Improved Technique

Abstract

Duodenal drainage studies have been difficult because of the amount of time the procedure takes. Much of this time is spent passing a tube into the duodenum. At this hospital a number of techniques have been tried. The best, heretofore, utilized the Dreiling duodenal drainage tube which is a double lumen tube with drainage openings separated by a small segment without holes. We encountered considerable difficulty with this tube even when the tip was in the duodenum because of the problem of keeping the bare area, which separates the gastric and duodenal drainage holes, across the pylorus. Therefore, we tried a small poly­ vinyl tube utilized in studies of intestinal absorption.i. 2 Methods The polyvinyl tube, which has an inside diameter of 1.7 mm. and an outside diameter of 2.5 mID., has adInirable characteristics of flexibility, withstands suction well without collapsing, and is not easily clogged. (The tubing was kindly provided by Don Baxter Inc., Glendale, Calif.) The tube we use now is approximately 8 feet in length, the tip is sealed by heating, and 6 to 8 side holes are cut in the distal 6 cm. of the tube. These are approximately 1.5 mm. x 3 mm. in size. A small thin plastic bag containing mercury is tied securely to the tip. A 15-gauge needle, ground to a flat tip, is easily inserted in the opposite end for connection to either a syringe or rubber tubing. The size of the tube as compared with the Dreiling tube is shown in figure 1. The procedure for duodenal intubation is