Biliary Tube Change or Stent

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A biliary drain is a tube to drain bile from your liver. It is put in by an Interventional Radiologist. The tube or catheter is placed through your skin and into your liver. You may also hear your drain called a biliary stent or biliary catheter. The liver makes bile, which helps with the digestive process. The ducts carry the bile from the liver to the bowel. When the bile ducts are blocked, a biliary drain must be placed or the bile will back up causing a yellow skin color (jaundice), dark urine, light stools, nausea, poor appetite and sometimes itching. The biliary drain will relieve these symptoms by draining the bile from the liver. A biliary drain may be placed because of leakage or a hole that forms in the bile duct. This leakage can cause severe pain or infection. Biliary drains also may be placed before surgery or for removal of a bile duct stone.

Need to Know

Nice to Know
  • You will be asked to sign a consent form before the procedure is performed
  • Tell your radiologist about any allergies, especially to local or general anesthetics and contrast materials (“x-ray dye”)
  • If you are taking a blood thinner or aspirin product, the physician will instruct you when to stop taking these medications
  • Do not eat anything after midnight. You may take your normal morning medicines with a sip of water
  • Plan to stay in the hospital for at least 24 hours after the exam so that we can watch you closely
  • Inform your radiologist if you are pregnant
  • If you are diabetic, the physician will give you insulin and/or anti-diabetic medication dosing instructions
  • Wear comfortable, loose-fitting clothing
  • You will be given a gown to wear during your treatment
  • You can go home after the procedure if vitals are stable
  • Most patients feel minimal discomfort after the procedure

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How Does It Work?

If you have a blockage of the bile ducts, this procedure can show where the blockage is, how severe the blockage is, and what has caused it. It can be used to make some patients with long-term blockage more comfortable. Sometimes it is done to prepare for surgery. It can help the doctors see where the bile duct problems are so they know where to operate later. If there has been trauma to the bile ducts such as a hole made by an injury, it can help prevent complications or control pain and infection. Sometimes it is a way to insert an internal stent (a device to open up narrowed ducts). When patients have a bile infection (cholangitis) it is sometimes part of the treatment to drain the infected bile. The tube may be left in for a few days or permanently. It depends on the reason you need the tube placed. Patients who have biliary drainage tubes placed need to have them changed in our department every 6-8 weeks. Sometimes they are removed earlier than that. We will make a follow-up visit for you when the tube needs to be changed

What Happens — Before, During, and After?

Clinical staff member will bring you into the pre-procedure area and ask you to change into a gown. An intravenous (IV) line will be inserted into a vein in your hand or arm. You will be given antibiotics. Your doctor will greet you, review the procedure, and answer any questions you may have. You will be brought into the procedure room, and you‘ll be positioned on the procedure table. You will be connected to a monitor for your heart rate, blood pressure, and pulse. The technologist will shave, sterilize, and cover the area of your abdomen where the catheter will be inserted with a surgical drape. The doctors will wear sterile gowns and masks. After review of your x-rays and the use of the above techniques, the doctor will mark the area on your right or left side.

The procedure is done with sedatives and pain medicine. Many times the patient will be “sleepy”. There will be a nurse or anesthesiologist checking your pulse, blood pressure, and temperature. The needle and the tube are placed using fluoroscopy. Using fluoroscopy, a small needle is placed in the liver. The doctors will remove the needle and replace it with a soft tube (catheter) in the bile duct that needs to be studied. After placing the tube into the bile duct, a small amount of contrast (x-ray dye) will be given to see how bile flows. Fluoroscopy will be used to see the ducts when the contrast goes in. The other end of the bile tube may remain outside your body to drain bile into a bag. If this is the case, the bile tube is fastened at the skin surface with stitches. A dressing is placed over the tube and kept in place with tape.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or – as you’re doing now- educate yourself about the procedure.

Another important part of your preparation will be guided by your doctor:

  • Several days before the procedure, you may have an office consultation with the interventional radiologist
  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin, Warfarin, Plavix, Fragmin) for a time before the procedure
 

Some of your preparation will need to be timed to the procedure:

  • The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a clinical staff member from the Interventional Radiology Department will call you. The clinical staff member will give you any additional instructions, and will ask if you have any questions.
  • Take your medications as instructed
  • When you arrive, make sure the clinical staff member and radiologist know about any allergies you may have, especially allergies to local anesthetics (such as lidocaine), general anesthetics, or x-ray dye (contrast media). If there’s any chance you might be pregnant, tell your radiologist.
 

Keep in mind in planning for this procedure that you should plan to have someone take you home after the procedure as you will not be able to drive after sedation.

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What Should I Bring?

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What Are the Benefits and Risks?

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