Radiology (Xray)

Percutaneous Biliary Drainage & Stent

Contact: RVI: (0191) 282 5627; Freeman Hospital: (0191) 223 1012


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Content (Please click on question/topic below to go to information)

Q1. What is a Percutaneous Biliary Drainage?

Q2. What is a Biliary Stent?

Q3. Who decided that I needed this procedure?

Q4. What preparation will I need?

Q5. What happens during a Biliary Drainage?

Q6. Local Anaesthetic

Q7. Will it hurt?

Q8. What happens afterwards?

Q9. What are the risks and complications?

Q10. What if I have any comments, questions or suggestions?

Q1.  What is a Percutaneous Biliary Drainage?

A1.  You have what is called “obstructive jaundice” which is usually caused by a blockage in the bile duct between the liver and the duodenum.  In order to relieve the blockage, a tube is inserted through the skin and into the liver to drain the bile. The drainage tube takes bile fluid from the liver into a collecting bag outside the body.

 

Q2.  What is a Biliary Stent?

 

 

 

 A2.  The ordinary biliary drainage tube hangs outside the body and is connected to a bag. A biliary ‘stent’ is an ‘inner tube’, which can be used to replace the externally draining system. It is a short, fine plastic or metal tube, which is usually inserted at the same time as the external tube is taken out.

Q3.  Who decided that I needed this procedure?

A3. Your doctors will have discussed the possible treatment options with the interventional radiologist (X-ray doctor) responsible for performing these procedures. There will be an opportunity for you to discuss the treatment with your doctors and with the interventional team.  This is a good time to mention any allergies or other conditions you have. You will be asked to sign a consent form after you have fully considered all the advice given.  If you do not want to undergo this treatment, then the procedure will be taken no further.

 

Q4.  What preparation will I need?

A4.  You will need to be admitted to hospital in order to undergo this treatment. You will be asked to put on a hospital gown and you will be examined by the doctors and nurses on the Ward  It is very important that you inform the nursing and medical staff about all allergies and medications. If you have had reactions to intravenous contrast medium, the dye used for kidney X-rays (IVPs) and for CT scanning, then you must also tell your doctor about this. A small plastic cannula will be inserted into an arm vein so that antibiotics may be given. Infection is often present in the obstructed bile duct, which is why you will be given antibiotics prior to attending the X-ray department.

 

You may eat a light meal at least 2 hours prior to the procedure and fluid intake should not be restricted.

 

Q5.  What happens during a Biliary Drainage?

A5.  After the admission procedures on the ward, a nurse will accompany you to the X-ray Department.  Here, the radiology nurse will discuss basic details of the procedure with you and the interventional radiologist will answer any further questions you may have.  You will be transferred onto the X-ray table, on your back. Monitoring devices will be attached to your chest and one finger. A blood pressure cuff will be put on your arm.

 

To aid relaxation through the procedure, sedative drugs are given soon after you get onto the table. Your skin will be cleaned with antiseptic in the low right side of your chest and local anaesthetic (see below) will be injected into the skin and soft tissues.  A fine needle is inserted into the liver and a guide wire passed through this. The needle is removed over the wire and replaced by a fine plastic tube or ‘catheter’, which is then passed through the obstruction in your bile duct using the X-rays as a “road map”. The catheter will then be fixed to the skin and a drainage bag attached.  The length of the procedure can vary, but expect to spend up to one and a half hours in X-ray.

 

Q6. Local Anaesthetic

  • Your radiologist will ask you to keep quite still while the injections are given.
  • You may notice a warm tingling feeling as the anaesthetic begins to take effect.
  • Your procedure will only go ahead when you and your radiologist are sure that the area is numb.
  • If you are not having sedation, you will remain alert and aware of your surroundings.  A screen shields the operating site, so you will not see the procedure unless you want to.
  • Your radiologist is always near to you and you can speak to him/her whenever you want to. 

Q7.  Will it hurt?

A7.  There may be some discomfort as the needle track through the liver is stretched to allow passage of the drainage tube. At this point, a strong pain-killing drug is often injected through the tube in your arm and you will feel slightly drowsy. Oxygen may be given through a face mask.

 

Q8.  What happens afterwards?

A8.  On your return to the ward, you will have to lie flat in bed for six hours. The nurses  will monitor your blood pressure and pulse frequently during this period.  You will then be able to move gently around the ward. The drainage bag will be emptied regularly and the contents measured. The length of time that the external drain remains in place will depend on your condition and will be discussed by your doctor.

 

Q9. What are the risks and complications?

A9 .There is often a small leakage of bile around the drainage tube but this is usually a minor problem.

 

Biliary drainage is a safe procedure but there are two main complications, occurring in less than 5% of cases: bleeding around or into the liver and infection of the blood stream.

 

When bleeding occurs it is often not significant.  Occasionally, this can increase and lead to the need for blood transfusion but can increase and may then lead to blood transfusion. Very rarely, a small operation is needed to block the bleeding artery.

 

In a few cases, bacteria may enter the bloodstream causing an infection, which will require continued antibiotics through the plastic tube in your arm. 

 

Q10. What if I have any comments, questions or suggestions?

 

Should you have any suggestions or concerns, please make these known to the person conducting your examination, or by letter addressed to the hospital you are attending your appointment:

 

Royal Victoria Infirmary

The Departmental Manager

X-ray Department, Level 3

Royal Victoria Infirmary

Queen Victoria Road

Newcastle upon Tyne

NE1 4LP

 

Tel: (0191) 282 1099

 

 

Freeman Hospital

The Departmental Manager

Main Xray

Freeman Hospital

High Heaton

Newcastle upon Tyne

NE7 7DN

 

Tel: (0191) 282 1099

 

All Newcastle Hospitals: Switchboard Tel: (0191) 233 6161

 

If you need to turn to someone for on-the-spot help, advice and support, please contact the Patient Advice and Liaison Service (PALS) on: Freephone 0800-032-02-02

 

Due to the transformations of the Newcastle Hospitals, please see ' Patient and Visitor Guides' to check map details for updates.

Alternatively, please see local map details on how to get to the new Victoria Wing, RVI and the Freeman Hospital.  The Freeman Hospital is to the east of the City of Newcastle upon Tyne with public transport services close by. Buses are available to and from the city centre direct to the main hospital entrance. A clearly sign-posted car park is provided for patients and visitors for which a charge applies.

All patient information is available in large print size for people with visual impairments or partial vision.  Please click on the link above, 'large print size' to view and print the document or alternatively, please click on the large 'A' at the top of the screen to read this information on-line.

 

Information produced by: Dr J Rose, Clinical Directorate of Radiology

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