What is a biliary catheter?
A biliary catheter is a tube that goes through your skin and liver into your bile ducts to drain your bile. In some cases, the bile drains out of your body into a drainage bag. In other cases, the catheter drains the bile into the bowel and you do not need a bag on the outside. Reasons for needing a biliary catheter include: blockage of the bile ducts, the presence of a hole in the bile ducts, and as preparation for surgery on the bile ducts.
What problems can occur with my biliary catheter?
The main problem that can occur is infection, skin infection around the catheter and bile duct infection. A skin infection can be prevented by taking good care of the skin around the catheter. If a skin infection occurs in spite of good skin care, the infection is usually simple to treat.
A bile duct infection occurs if the catheter gets blocked. The best way to avoid this is to keep your biliary catheter flushed.
How do I take care of the skin around my biliary catheter?
Follow these instructions unless your doctors specify otherwise:
- Keep the skin around your biliary catheter dry. You can take showers if you cover the area with plastic wrap. Tape the edges of the plastic wrap to your skin so that water cannot get under it. If the area does get wet, dry the skin completely after your shower.
- Keep the skin around your biliary catheter clean. Clean the area every day or every other day with a cotton swab that has been moistened with peroxide. Always wash your hands before you clean the catheter site.
- Keep the skin around your biliary catheter covered. After cleaning the skin around the catheter insertion site, cover the area with a clean bandage or dressing. Change the dressing if it gets wet.
What are signs of a skin infection? What should I do for a skin infection?
Signs of a skin infection are redness, soreness, and swelling of the skin around the catheter. If you notice any of these signs, even if they are very mild, you should follow these instructions unless your doctor specifies otherwise:
- Clean the skin site more often. If you usually clean the skin and change the dressing every other day, start cleaning the skin and changing the dressing every day. If you usually clean the skin and change the dressing once a day, do this twice a day.
- Apply antibiotic ointment to the skin around the catheter after each time you clean it.
- If your symptoms of skin infection do improve promptly, keep up the extra care for a total of one week, and then go back to your usual skin care routine.
How do I keep my biliary catheter from becoming blocked, so that I won’t get a bile duct infection?
Sometimes, despite your best efforts, your biliary catheter can become blocked. The following instructions can reduce the risk:
Flush your biliary catheter with sterile saline as your doctor recommends. Usually, this is once a day. Flushing the catheter with saline keeps the inside of the catheter as clean as possible.
If your biliary catheter drains bile into an external drainage bag, rinse the bag out with water every day. It is best to have two bags so that you have one to wear while you are rinsing the other one.
Keep your appointments to have your biliary catheter changed. In most cases, the catheter is changed every two to three months. It is much easier to change the catheter than it is to place the original catheter. This change can usually be done as an outpatient.
How do I know that my biliary catheter is blocked? What are signs of a bile duct infection?
These two problems frequently go together. A sign that your catheter is blocked is leakage of bile around the catheter. Signs that you have bile duct infection are fever and chills.
What should I do if I think my catheter is blocked and/or I think I have a bile duct infection?
Call your interventional radiologist and/or primary doctor immediately. These doctors will arrange for prompt treatment of your problem. In most cases, you will need to have your catheter changed and you may need antibiotic medicine. You may even need to be admitted to the hospital. If your tube is capped off, uncap it and connect it to a drainage bag.
What supplies will I need to take care of my biliary catheter?
You will need to buy:
- hydrogen peroxide
- cotton swabs or cotton balls
- gauze pads
- surgical tape
- antibiotic ointment
- sterile saline
- drainage bags
These are available at drug stores and hospital supply stores. Your doctor will let you know if there are supplies you need that are not on this list.
Do I have to limit my activity?
You will be sore for one to two weeks after your catheter is first inserted. This will limit your activity. After that, you should continue to avoid any activity that causes a pulling sensation or pain around the catheter. There are no special diet instructions.
I know I need to call my doctor if: I have a skin infection that does not go away with care at home, I think my catheter is blocked, or I suspect a bile duct infection. Are there other times I should call my doctor about the catheter?
Yes. Call your doctor immediately if:
- your catheter becomes dislodged or broken.
- you have stitches and they become loose.
- your catheter begins to leak.
- there is blood in or around your catheter.
Which doctor do I call about my biliary catheter?
Most people who need a biliary catheter have more than one doctor. Your catheter was placed by a specially trained doctor called an interventional radiologist. This specialist works with your other doctors (such as your surgeon, internist, or family doctor) to take care of you once you have a biliary catheter. Your team of doctors may prefer that you contact your interventional radiologist directly if you have a question or problem relating to your catheter. Or, your medical team may prefer that you contact your surgeon, internist, or family doctor first.