Successful performance of endoscopic sphincterotomy in the treatment of choledocholithiasis led to the placement of retrograde, transpapillary catheters for internal drainage and prevention of cholangitis. This technique presented the opportunity for using nasobiliary tubes for short term treatment of this problem or placing a permanent drain into the bile duct for long term management. Internal drains placed endoscopically have been used on 15 occasions: 10 nasobiliary and five permanent. These drains have functioned well without complications prompting us to recommend this approach in patients with benign or malignant obstruction of the biliary tree.