Biliary Drainage

(also called Percutaneous Biliary Drainage)

Your liver produces bile, a fluid that helps break down food, especially fat. The fluid flows from the liver through tiny bile ducts into the common bile duct and then empties into the first part of the small intestine (duodenum). Sometimes, the bile ducts become narrowed or blocked due to a scar, a tumor, or gallstones, causing the bile to collect in the liver. This backup can cause infection, nausea, vomiting, fever, and jaundice (yellowing of the skin).

When the bile ducts become blocked, an interventional radiologist may place a catheter (a thin, hollow tube) percutaneously (through the skin) into your abdomen to drain the bile from the liver to a bag outside your body or back into your intestine.

What happens during biliary drainage?

You will have already discussed the treatment options with the physician doing the procedure. We may conduct additional imaging tests to help us plan the biliary drainage procedure.

Prior to your procedure, we’ll take you to a preparation area where our nurses will start an IV in your arm and give you any medication that may be required prior to your procedure. When it’s time to begin, we’ll take you to a special room that is similar to an operating room.

We usually use conscious sedation, or moderate anesthesia, during a biliary drainage procedure. In this case, you’ll remain slightly awake throughout the procedure. We will monitor your pulse, blood pressure, and your breathing throughout the procedure.

During the procedure, you’ll lie on your back on a table and we’ll clean the area where the catheter (a thin, hollow tube) will enter your body with a special solution to minimize infection. We’ll place sterile drapes over your body and an interventionalist will apply a local anesthetic so you don’t feel any pain.

Your interventionalist will make a small cut in your abdomen (on the front or side) and then pass a thin needle into your liver to the bile duct using ultrasound or a contrast dye and imaging technique (fluoroscopy), or both, to guide the placement. We’ll insert a guide wire and then a catheter into the blocked bile duct. If possible, we’ll cross the blockage so the tube may be passed all the way into the intestine. The back of the catheter will be attached to a drainage bag on the outside of your body.

After the procedure, we will teach you how to flush and drain your catheter and change the dressing. You’ll need to empty the drainage bag regularly. Plan to have someone drive you home after the procedure.

Your interventionalist will review the results of your biliary drainage with you and your physician so he or she can discuss the next steps with you. We may ask you to return so the interventionalist can check how well you have done after your procedure, and to see if you need any other procedures to make you better.