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.

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18 patients with aortic aneurysm were examined by angiography and computed tomography. Dissection was found in 10 Patients. It was not possible to accurately determine the proximal and distal extension of the aneurysms via any of the two methods. Vascular sclerosis and thrombi were more clearly visualised in the computer tomogram, but it was not always possible to accurately visualise vascular ramifications. In spite of the fact that the informative value of the computer tomogram is not always satisfactory if effected preoperatively, especially with dissecting aneurysms, a CT should be done as far as possible before angiography.