Percutaneous Biliary Drainage
What is percutaneous biliary drainage?
Percutaneous biliary drainage is a procedure that drains bile from the liver.
A tube is placed through the skin into the liver to relieve jaundice (yellowing
of the skin) caused by a blockage in the bile duct.
Why do I need percutaneous biliary drainage?
Usually, the goal is to relieve jaundice caused by a blockage of the bile ducts
that drain bile from the liver into the intestine. Gallstones, tumors or scarring
may cause a narrowing or stricture, blocking the flow of bile from the liver
into the intestine. Bile collecting in the liver can be harmful, but percutaneous
biliary drainage provides relief by diverting the obstructed bile to the outside
of the body.
How is percutaneous biliary drainage performed?
Prior to your procedure you will be asked to undergo the following tests or
procedures to evaluate your condition:
History and Physical Examination
Imaging (CT, MRI, MRA)
The procedure is performed in the interventional radiology suite. First,
the nurse will give you a sedative through the intravenous line, which will
be placed in your arm. You will feel relaxed and sleepy, but you will be
awake throughout the procedure. The Interventional Radiologist will numb
an area of your abdomen with a local anesthetic. After you are given a local
anesthetic, the Interventional Radiologist will insert a small needle into
your liver. Through this needle, contrast (x-ray dye) will be injected to
see your bile ducts and the catheter, or drainage tube, will be placed into
the bile ducts. The catheter will remain in place to drain bile into a drainage
bag. The catheter is secured to your abdomen to hold it in place. A dressing
is then applied to the catheter entry site.
What will happen after the percutaneous biliary drainage?
After the procedure, you will return to your hospital room. Your nurse will
check the catheter. The bile will drain outside your body into a drainage bag
for several days. If the blockage in the liver is very tight, the Interventional
Radiologist may have initially placed the drainage catheter above the blockage
site. If this is the case, then you will return to the interventional radiology
suite after 2 or 3 days and the Interventional Radiologist will pass the catheter
through the blockage and into the small bowel. Once the end of the catheter
is in the bowel the drainage bag can replaced by a cap and the bile will drain
internally from the bile ducts into the bowel.
You should keep the skin around your biliary catheter clean and dry. You can
take a shower, but you should tape plastic wrap or a plastic bag around the
bandage. Clean the tube site daily with hydrogen peroxide and allow the skin
to dry. Apply a sterile gauze dressing and attach with paper tape. The catheter
should be flushed once a day in order to clean any debris out of the holes in
the catheter. Flush with 10 ml of saline. Push the saline in towards the catheter
(not the drainage bag). Flush slowly in only. Do not pull back fluid into the
syringe. By pulling the solution back into the syringe, you may pull the debris
back into the catheter.
Problems you should be aware of:
1. If the skin around the catheter becomes red and sore, you may have a skin
infection. Apply some antibiotic ointment to the skin when you change the bandage.
If it does not clear in two days, call your primary care doctor.
2. If you develop a fever greater than 100° fahrenheit, chills or vomiting,
you should call your primary care doctor immediately.
3. If your catheter begins to leak around the skin site onto the bandage, it
needs to be changed. If this occurs at night, call the office the following
morning for an appointment at (305) 932-7800. If your catheter has been capped
and you have a drainage bag in storage, connect the catheter to external drainage.
4. If your catheter falls out, call the office immediately at (305) 932-7800.
Usually, a catheter that has fallen out can be easily replaced with a new catheter
if performed within 24 hours.