Biliary drainage, also called percutaneous biliary drainage, is the common treatment for clearing gallstones and other blockages from the bile ducts. The bile ducts carry bile from the liver to the gall bladder and small intestine to aid in digestion.
During biliary drainage, an incision is made through the skin into the liver where a stent is placed to hold the bile duct open. A biliary drainage tube, or catheter, is then inserted to clear the bile ducts of any existing obstructions. If the bile duct is blocked by gallstones, surgery to remove the gall bladder is usually performed. In the case of cancer in the region, the bile duct may be widened during an endoscopic procedure.
Reasons for Biliary Drainage
When the bile ducts are functioning normally, they allow bile, a green-brown fluid produced by the liver, to drain from the liver into the small intestine to aid in the digestion of fats. When the bile ducts are blocked, bile cannot be excreted and builds up in the liver, resulting in an excess of bilirubin, the active ingredient in bile, in the blood. Reasons for bile duct obstruction may include:
- Gall stones
- Pancreatitis, or inflammation of the pancreas
- Cholangitis, or infection of the bile duct
- Tumors, benign or malignant, in the region
- Enlarged lymph nodes in the region of the pancreas
- Cysts in the bile ducts
The bile ducts may be obstructed because of injury or scarring of the bile ducts from a previous surgery, commonly a cholecystectomy, or gallbladder removal.
Symptoms of Bile Duct Obstruction
When bilirubin accumulates in the blood, it creates a serious situation which may result in the following symptoms:
- Dark urine
- Pale stools
- Intense itching
- Nausea and vomiting
Severe abdominal pain, especially in the right upper quadrant, may also be a symptom of bile duct obstruction.
Diagnosis of Bile Duct Obstruction
Diagnosis of bile duct obstruction is made through several diagnostic test, which may include blood and urine tests, abdominal ultrasound, CT scan, MRI of the region, or an endoscopic cholangiopancreatography, or ERCP.
Risks of Bile Duct Drainage
While bile duct obstruction carries a number of serious risks, bile duct drainage is usually a safe procedure. Possible complications of bile duct drainage may include:
- Excessive bleeding
- Postsurgical Infection
- Bile leakage
- Breathing difficulty
- Adverse reaction to anesthesia or medication
These complications are rare. Most patients undergoing biliary drainage go through a smooth and successful recovery. The risks of leaving a biliary obstruction untreated are much more dire.