MEASUREMENT of bile output and quantitative analysis of biliary constituents require the establishment of a total biliary fistula. Changes in the composition of the bile and possibly also in its flow rate are likely to happen from the interruption of the normal enterohepatic circulation associated with a total fistula and it is, therefore, desirable to have controlled fistula, one that allows return of bile flow to the intestine as soon as the collection of samples is over with.
The catheter described here fulfills these requirements and has been used successfully for this purpose. The distal end of the catheter is blind but has an inflatable balloon (Fig 1). Immediately proximal to the balloon are three openings in the catheter placed 1 cm apart.
The catheter is inserted following cholecystectomy through the cystic duct and common bile duct into the duodenum. The balloon is inflated with 2 ml of saline and