Biliary Drainage

Biliary drainage, also called percutaneous biliary drainage, is a common treatment for clearing gallstones and other blockages from the bile ducts. The bile ducts carry bile from the liver to the gallbladder 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 (catheter) is then inserted to clear the bile duct of any obstructions. If the bile duct is blocked by gallstones, surgery to remove the gallbladder 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 include the following:

  • Gall stones
  • Pancreatitis (inflammation of the pancreas)
  • Cholangitis (infection of a bile duct(s))
  • Tumors, benign or malignant, in the region
  • Enlarged lymph nodes in the region of the pancreas
  • Infection
  • Cysts in the bile ducts

A bile-duct injury that occurs during cholecystectomy surgery (gallbladder removal) can also cause an obstruction.

Symptoms of Bile Duct Obstruction

When bilirubin accumulates in the blood, it creates a serious situation that can cause following symptoms:

  • Dark urine
  • Pale stools
  • Jaundice
  • Fever
  • Intense itching
  • Nausea and vomiting

Severe abdominal pain, especially in the upper-right quadrant, can also be a symptom of bile duct obstruction.

Diagnosis of Bile Duct Obstruction

Diagnosis of bile duct obstruction is made through several diagnostic tests, which include blood and urine tests, abdominal ultrasound, CT scan, MRI scan, or endoscopic cholangiopancreatography (ERCP).

Risks of Bile Duct Drainage

Although bile duct obstruction carries a number of serious risks, bile duct drainage is usually safe. Possible complications of bile duct drainage include the following:

  • Excessive bleeding
  • Postsurgical infection
  • Bile leakage
  • Breathing difficulty
  • Adverse reaction to anesthesia or medication

These complications are rare, and most patients undergoing biliary drainage have a smooth and successful recovery. The risks of leaving a biliary obstruction untreated are much more serious.

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