Percutaneous Transhepatic Biliary Drainage

WHAT YOU SHOULD KNOW:

  • Percutaneous transhepatic biliary drainage (PTBD) is a procedure that opens a blocked bile duct. Your bile duct is like a network of pipes that go from your liver to your gallbladder, pancreas, and small intestine (bowel). Your liver is an organ that makes fluid called bile, which is stored in your gallbladder and helps digest food. Digestion is the process of the body breaking down food that is eaten. When bile reaches your small intestine, it helps break down the fat in your food. The pancreas is an organ that helps you digest food.

  • You may need PTBD if your bile duct is blocked because of swelling, infection, growths, or small stones. During PTBD, your caregiver puts a tube in your bile duct to drain out bile. You may have the tube for a short time, or it may be long-lasting. After PTBD, your body may digest food more easily. Abdominal pain and jaundice (yellowing of your skin and the whites of your eyes), may decrease. PTBD can help you get the nutrition that you need to feel better and be healthier.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may be allergic to the dye used for tests that are done before or during the procedure. Your gallbladder, bile duct, or blood vessels may be damaged. You may lose too much blood and need a blood transfusion. After the procedure, there may be swelling or bleeding around the tube, and it may be painful. The skin around the tube may get infected. The tube may move out of place, get blocked, or fall out. Your gallbladder may become swollen or infected. You could get a blood clot in a blood vessel in your liver. You could get an infection in your lungs. You may need treatment for any of these problems.

  • If you do not have percutaneous transhepatic biliary drainage, you may not have enough bile in your intestines to digest food. Your body may not get the nutrition it needs. Bilirubin may build up in your liver and bile duct. You may get jaundice and your eyes and skin may turn yellow. Your gallbladder may burst. With or without PTBD, you may die from infection. Call your caregiver with questions about your condition, the PTBD procedure, or your care.

WHILE YOU ARE HERE:

Before your procedure:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Antibiotic medicine: Your caregiver may give you antibiotic medicine to help prevent or treat an infection.

  • Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.

    • Local anesthesia: Local anesthesia is medicine that is given through a needle into your abdomen. You may feel pressure during the procedure but you should not feel pain. With local anesthesia, you will be awake during the procedure.

    • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

    • General anesthesia: General anesthesia is medicine that may be given through your IV, or as a gas that you breathe. With general anesthesia you will be asleep during the procedure.

  • Endoscopic retrograde cholangiopancreatography (ERCP): This procedure may be done before percutaneous transhepatic biliary drainage to remove stones in your gallbladder or bile duct. Ask caregivers for information about ERCP.

During your procedure:

Caregivers use fluoroscopy or computed tomography (CT) to see your bile duct during the procedure. Your caregiver puts a needle through the right side of your abdomen, and into your liver. A wire is pushed through the needle into your liver. If you have stones blocking your bile duct, the wire is used to break them up. Your caregiver puts a tube over the needle, and then removes the needle and wire. A small part of the tube goes through your skin to the outside of your body. If the tube is capped closed, bile will drain into your intestines. If the tube is left open, bile will drain into a bag that is attached to the end of the tube outside of your body.

After your procedure:

You are taken to a room to rest. Do not get out of bed until caregivers say it is okay. When caregivers see that you are okay, you may be able to go home. If you are staying in the hospital, you are taken to your room.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Percutaneous Transhepatic Biliary Drainage (Inpatient Care)

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