1. The biliary drainage catheter is a plastic stent that provides either internal or internal/external drainage of the bile from the liver. These catheters are typically colonized with bacteria, so with catheter exchanges patients may develop symptoms due to infection. Any unusual tenderness, upper abdomen pain, chills, or fever should be reported to Dr. Osterman at (305) 932-7800.

2. Following your procedure and discharge from the hospital you should go home and rest for the remainder of the day. Do not drive, operate appliances, or make any legal decisions for the day.

3. Have a responsible adult drive you home. You may wish to have a responsible adult or relative remain with you for the remainder of the day.

4. You may resume your normal diet following the procedure. Drink extra fluids (six to eight glasses per day) while the catheter is in place. Avoid alcoholic beverages or depressant drugs for 24 hours.

5. Do not take aspirin-containing products Ibuprofen, vitamin E, or blood-thinning products (*Coumadin) for at least 24 hours. You may take Tylenol (1 to 2 tablets every four to six hours) for mild discomfort at the tube site. If you develop severe pain, swelling, or redness at the catheter insertion site call Dr. Osterman's office at (305) 932-7800.

6. You will be sore for one to two weeks after the initial catheter insertion. Subsequent tube changes will result in tenderness at the site for 24 to 48 hours. This may limit your activities. After that, you should continue to avoid any activity that causes a pulling sensation or pain around the catheter or kinking of the catheter. You may take a shower, but cover the dressing with plastic wrap so that it does not get wet. Following the shower, remove the plastic wrap and the dressing. Clean the tube site with hydrogen peroxide and allow the skin to dry. Then apply another sterile gauze dressing and attach with paper tape.

7. Flush your biliary catheter with 10 cc of sterile saline once daily.

8. If you are unable to care for your catheter, your primary care physician will assist in arranging for a visiting Home Health Care Nurse. The nurse will teach you how to care for the catheter site and dressing.

9. Call the office immediately at (305) 932-7800 if you have pain in your side, if your catheter becomes dislodged or broken, if your catheter begins to leak, if there is no drainage from the catheter that is open to a drainage bag, or if the skin around the catheter has purulent discharge or starts to break down.

10. Report a temperature greater than 100º Fahrenheit (38.3º Celsius) to Dr. Osterman's office at (305) 932-7800.

11. You will be scheduled to have future appointments for catheter changes. The percutaneous bile drainage catheter may be changed as often as 8 to 12 weeks. Changing the catheter helps prevent it from becoming blocked. It is much easier to change a catheter than it is to place the original catheter. The catheter exchange can usually be done on an outpatient basis.

12. If you have any questions or complications should develop after you arrive home, please do not hesitate to call Dr. Osterman at (305) 932-7800

In most cases Coumadin therapy may be re-started 3 days after the procedure. You may discuss this with Dr. Osterman after the procedure or call the office for instructions.