What Is a Biliary Intervention?

Biliary interventions are minimally invasive procedures that treat narrowed or blocked bile ducts. The liver makes bile, which helps with the digestive process. These ducts carry the bile from the liver to the bowel. When bile ducts are blocked, a biliary drain must be placed or the bile will back up, causing a yellow skin color (jaundice), dark urine, light stools, nausea, poor appetite and sometimes itching. A biliary drain, also known as a billiary stent or biliary catheter, is a tube placed through your skin and into your liver that drains bile from your liver.

A biliary drain may also be used if there is leakage or a hole that forms in the bile duct, which can cause severe pain or infection. Biliary drains also may be placed before surgery or for removal of a bile duct stone. Other minimally invasive techniques can also be used to treat an inflamed or infected gallbladder.

How It Works
During the procedure, you will receive pain medicine and sedation to help make you comfortable. The doctors will also use a local anesthetic to numb the skin and the deep tissues where they will be working. You will still feel pressure during the procedure, but no pain.

Placing your biliary drain will take about two hours. The interventional radiologist will place a needle in the bile duct, insert a wire through the needle into the duct, and then remove the needle. The radiologist will then place the drain over the wire and remove the wire, leaving the drain in place. The drain is then connected to a drainage bag.

Before Your Procedure
Generally, no solid food is allowed after midnight on the night before the procedure. You can drink clear fluids up to six hours before the procedure. Most people can continue to take their prescribed medicines with a small sip of water. If you are a diabetic or take a blood thinner, speak with your primary care physician for modified dosage directions. Bring all of your medications with you.

After Your Procedure
The symptoms you had before placement of the drainage catheter will typically improve over the first several days. The catheter will remain in place until it is no longer needed, depending on your treatment.

What Are the Benefits and Risks?
Benefits
Placement of a biliary drain will relieve symptoms from a blocked or leaking bile duct. Sometimes, the biliary catheter is a temporary solution, with other interventions ultimately resolving the blockage. A permanent stent or the permanent use of the biliary catheter may be required.

Risks
Biliary drain placement through the skin is a safe procedure that is performed instead of surgical placement. Complications can occur. The majority of complications are not serious but in rare instances can be life-threatening.

The two most frequent complications are bleeding and infection. Your bile will likely be tinged with blood for several days after the drain has been placed, but this typically stops, requiring no further treatment. Rarely, bleeding can occur that may require angiography or even surgery. Another complication could be a post-procedure infection. Before your procedure, a member of the interventional radiology team will discuss the risks and answer questions you may have.

What to Expect
Prior to appointments, Gwinnett Medical Center patients are asked to come in for routine lab work. It is preferred that patients have their lab work performed at Gwinnett Medical Center so the radiology nurses have access to the results. Our radiology nurses call each patient shortly after the procedure is scheduled to obtain a health history and provide instructions.

For most interventional radiology exams, patients need to arrive in admissions two hours before their scheduled procedure time on the day of the exam. Patients will check in at admissions before being taken to the Imaging Nursing Unit, where an interventional radiologist will come to talk with the patient before the procedure. The patient will then be prepped for the exam and taken to the Interventional Radiology Suite for the procedure. Following the procedure, the patient will return to the Imaging Nursing Unit for recovery. The recovery time varies based on the procedure. After the patient is then discharged, he or she will receive a follow-up call the next day.

Call 678-312-3444 to schedule an appointment at one of our convenient locations in Lawrenceville, Duluth or Hamilton Mill.