Taking duodenal contents holds a nurse by duodenal intubation .taking time: 8-9 hours in the morning.
Patient Preparation: cancel all medications containing pancreatic enzymes, at least one day prior to the study (preferably 3 days).
Probing conducted on an empty stomach after a 14-hour fast;allowed to drink some water (a few sips), but not later than 2 hours prior to the study.
position of the patient during the duodenal intubation: the probe is introduced into the patient sitting position - it must breathe and do active swallowing.the first label is in the teeth usually 5-10 minutes, ie,olive reaches the stomach.The patient is placed on the right side and placed under his cushion;He continues to slowly swallow the probe to the second mark.Further progress of the probe is carried out through the pylorus due to the peristalsis of the stomach - this period usually lasts 1.5 hours free end of the probe is lowered into one of the tubes that are to stand on the bench below the head of the patient..
While Olive is in the stomach of the probe follows the stomach contents - turbid liquid acid reaction.During the passage of the olive into the duodenum begins to flow into the tube transparent yellow bile alkaline reaction.Bile was collected into a separate series of small portions of the tubes (each tube - approximately 5 minutes).
Check the correct position of the probe can sample the air: a syringe in the probe introduced some air;when finding probe into the stomach of the patient feels air intake and rumbling;if the probe is in the duodenum, there are no sensations.
Bile is released drop by drop, unevenly, the first portion is usually golden yellow, transparent, slightly viscous consistency.This is due to the bile duct and gall portion designated as "A".
After 10-20 minutes after the release of bile is introduced stimulus that causes contraction of the gallbladder.Some stimuli are administered by gavage, for example 30-50 ml of 30% solution of magnesium sulfate, or olive oil, or egg yolks, 10% sorbitol solution.Other stimuli are administered parenterally.The best stimulus for gallbladder - cholecystokinin, which is administered intravenously at a dose of 75 IU (1 vial).After 15-20 min mark selection "cystic" bile dark olive green - a portion of the "B", typically in an amount of 30-60 ml.If, after the introduction of stimulus contraction of the gallbladder does not come, reintroduced the same stimulus.Duration discharge portion "B" - 10-15 minutes.
After emptying of the gallbladder is allocated a light and transparent hepatic bile - a portion of the "C".Upon receipt of the probe tubes 2-3 portions removed previously having passed through 20-30 ml glucose solution or water to remove bile.
All received portions of bile as fast as possible is delivered to CDL.Analysis of bile should be performed immediately after receipt, as cells can be destroyed by enzymes.
In carrying out of duodenal intubation probe introduced children to a smaller distance than the adults.This distance depends on the age:
• newborn - up to 25 cm;
• Children up to 6 months - up to 30 cm;
• up to 1 year - up to 35 cm;
• 2-6 years -40-50 cm;
• up to 6-14 years - 45-55 cm