A bile duct drain is a procedure that involves opening up obstructions or treating holes in the biliary system.
A bile duct drain, also called biliary drainage, can help treat blocked bile ducts so that bile may flow as it should, helping your liver digest fats.
Learn more about biliary drainage, including how it works, potential risks, and other important information to discuss with a doctor.
A biliary drain helps correct a blocked or narrow bile duct. It may also help redirect bile in cases where there are holes in the affected bile duct.
When a bile duct doesn’t function as it should, bile can back up into your liver or possibly leak into your abdomen. Left untreated, such bile duct issues may lead to serious complications such as severe pain, infections, and jaundice (skin yellowing).
Biliary drainage may be recommended as part of your treatment plan for the following conditions:
- bile duct injuries
- inflamed bile duct (sclerosing cholangitis)
- bile duct tumors
- other tumors that may develop in your liver, gallbladder, or pancreas
- enlarged lymph nodes that may accompany tumors
- biliary tree infection (cholangitis)
- gallstones
- pancreatitis
The exact procedure may vary based on the exact cause of bile accumulation, but you may expect the following general steps:
Before the procedure
Before the procedure, you may be prescribed antibiotics to help prevent possible infections. A doctor will also test your kidney function as well as your blood’s clotting abilities.
You may be asked to temporarily stop taking medications that may increase bleeding, such as blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs). You’ll also need to fast the night before your procedure.
During the procedure
During biliary drainage, a doctor will place a catheter in the obstructed bile duct. This small plastic tube is inserted through your skin and aims to help eliminate accumulated bile. The other side of the catheter is then connected with an external collection bag.
Stenting may be used a few days after the initial bile duct drain. This helps to open up the narrow or blocked bile duct to help bile drain internally.
After the procedure
After the procedure, you’ll be relocated to a recovery room where a nurse will monitor your vitals.
In all, you should be discharged within a few hours after biliary drainage. While this is an outpatient procedure, you’ll still need someone to drive you home.
Before you go home, a nurse will teach you how to care for your biliary drain at home. This involves changing bandages around the drain, as well as cleaning it daily with a saline solution. Additionally, you’ll need to empty the collection bag throughout the day before it gets full.
You may be a candidate for a bile duct drain if you have an underlying condition that’s causing narrowing or obstruction of one or more bile ducts. Possible symptoms of a bile duct problem include:
- jaundice
- fever
- abdominal pain
- dark urine
- pale stools
- nausea or vomiting
- itchy skin
- reduced appetite
- unintentional weight loss
Overall, biliary drainage is considered effective, particularly in bile duct conditions that are diagnosed and treated early. One example is acute cholangitis, where biliary drainage may be combined with antibiotics.
Not all obstructed bile ducts may be treated with a drain. For some people, more invasive surgeries may be needed to open up the blockage instead of biliary drainage.
The effectiveness rate of biliary drainage may also depend on the purpose of the procedure. For example,
While biliary drainage is considered a minimally invasive procedure, there are still potential risks and side effects to discuss with a doctor beforehand. These may include:
- bile leakage and accumulation in the abdomen (ascites)
- blood infections
- bleeding, which may be severe
- swelling, bleeding, or infections around the catheter
- migration of implanted stents (where they move in your body)
If you suspect you’re having side effects after having a bile duct drain, it’s important to contact a doctor right away. Any abdominal pain, gastrointestinal changes, or jaundice should also be reported.
If a doctor recommends biliary drainage, you’re likely to have many questions regarding the timeline and overall procedure. Here’s a few examples.
How long does a biliary drainage take?
Biliary drainage is an outpatient procedure. Typically, you’ll go home within the same day of your procedure, unless any complications arise during recovery that require hospitalization.
Who performs a biliary drainage and where is it done?
A biliary drainage is typically performed by a specialist called an interventional radiologist. They’re trained in performing procedures guided with imaging machines, such as X-rays and ultrasounds. Your procedure will likely take place in an outpatient radiology facility.
How long does a biliary drainage catheter stay in?
A biliary drainage catheter is typically changed every 2 to 3 months. The exact amount of time you need the catheter and drainage bag may vary based on your condition and how often you need to empty the bag.
What does bile drainage look like?
Bile, which is normally secreted by the liver and into the gallbladder via bile ducts, is yellowish-green in appearance. When you have a bile drain, you’ll notice this yellow-green substance flowing from the catheter into the collection bag.
Biliary drainage is a procedure used to help remove or redirect bile due to issues with your bile ducts. This outpatient treatment may be recommended for a variety of underlying bile duct issues, including infections, inflammation, and tumors.
