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Percutaneous Transhepatic Biliary Drainage


Percutaneous transhepatic biliary drainage (PTBD) is done to open a blocked bile duct.



The week before your procedure:

  • Write down the correct date, time, and location of your procedure.
  • Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.
  • Ask your healthcare provider if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  • Bring your medicine bottles or a list of your medicines when you see your healthcare provider. Tell your provider if you are allergic to any medicine. Tell your provider if you use any herbs, food supplements, or over-the-counter medicine.
  • You may need to follow a special diet before your procedure. You may need to see a dietitian who will teach you which foods to eat and which foods to avoid. If you drink alcohol, you may need to stop.
  • You may need to have blood tests and an EKG. You also may need x-rays, an ultrasound, a CT scan, or an MRI. Talk to your healthcare provider about these or other tests you may need. Write down the date, time, and location for each test.

The night before your procedure:

Ask healthcare providers about directions for eating and drinking.

The day of your procedure:

  • Ask your healthcare provider before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.
  • You or a close family member will be asked to sign a legal document called a consent form. It gives healthcare providers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  • Healthcare providers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell healthcare providers if you or anyone in your family has had a problem with anesthesia in the past.
  • Your healthcare provider may give you antibiotics to help prevent a bacterial infection.
  • You may have endoscopic retrograde cholangiopancreatography (ERCP) before your procedure. ERCP can help your healthcare provider plan your procedure. He may also remove stones or growths in your bile duct.


What will happen:

A CT scan or fluoroscopy may be used during the procedure. Your healthcare provider will put a needle through the right side of your abdomen and into your liver. A wire will be pushed through the needle and into your liver. Your healthcare provider will use the wire to break up the stones that block your bile duct. Your healthcare provider will put a tube over the needle and then remove the needle and wire. The tube will be left in place. A small part of the tube will come through your skin to the outside of your body. If the tube is capped, 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 will be taken to a room to rest until you are fully awake. You will be monitored closely for any problems. Do not get out of bed until your healthcare provider says it is okay. You will then be able to go home or be taken to your hospital room.


  • You cannot make it to your procedure.
  • Your skin or the whites of your eyes look more yellow than usual.
  • You have a fever.
  • You are nauseated, or you are vomiting.
  • Your bowel movements have changed color and are very light or dark.

Seek Care Immediately if

  • Your abdomen feels hard or is swollen or painful.


Your gallbladder, bile duct, or blood vessels may be damaged. You may bleed more than expected. After the procedure, you may have swelling or bleeding around the tube. The skin around the tube may get infected. The tube may move out of place or get blocked. Your gallbladder may become swollen or infected. You could get a blood clot in your liver. You could get a lung infection. Your lungs could fill with blood or air, making it hard for you to breathe.

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 healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

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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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Percutaneous Transhepatic Biliary Drainage (Precare)

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