Percutaneous Biliary Drainage

Bile is made in the liver and stored in the gallbladder. It helps digest food. Bile normally passes out of the liver through a series of tubes (ducts). Bile can back up into the liver if a duct becomes blocked. It can also back up if a hole or tear forms in a duct. Biliary drainage is a procedure to drain bile from the liver. The procedure is done by a specially trained doctor called an interventional radiologist.

Front view of liver, stomach, small intestine, gallbladder, and common bile duct.

How do I do get ready for biliary drainage?

Follow any instructions you are given on how to get ready. These include:

  • Follow any directions you’re given for not eating or drinking before the procedure.

  • Tell the technologist if you are or could be pregnant,or  if you are breastfeeding.

  • Tell the technologist if you are allergic to X-ray dye (contrast medium) or other medicines.

  • Be sure your doctor knows about all medicines you take. You may be told to stop taking some or all of them before the test. This includes:

    • All prescription medicines

    • Over-the-counter medicines that don't need a prescription

    • Any street drugs you may use 

    • Herbs, vitamins, kelp, seaweed, cough syrups, and other supplements

What happens during biliary drainage?

  • You will change into a hospital gown and lie on an X-ray table.

  • An IV (intravenous) line will be put into a vein. This is to give you fluids and medicines. You may be given medicine to help you relax and make you feel sleepy.

  • The skin on your stomach is cleaned. Medicine is put on the skin to numb it.

  • A needle is put into the liver. Contrast medium is injected into the ducts. This helps the duct system show clearly on X-rays.

  • A thin, flexible tube (catheter) is put in and moved into the liver. The radiologist uses X-ray or ultrasound pictures as a guide. He or she moves the catheter into the duct that needs to be drained.

  • Bile drains through the catheter out of your body. A bag is attached to the end of the catheter to collect the bile as it drains.

  • The catheter may be temporarily sutured or taped to your skin to keep it secure and prevent it from moving.

  • The radiologist may be able to use the catheter to clear the blockage during the procedure. In this case, a mesh tube (stent) may then be put in the duct to help keep it open. This allows the catheter to be taken out, usually at a later time.

What happens after biliary drainage?  

  • A slight fever (1°F above your normal temperature)  is normal for the first 24 hours after the procedure. If the fever lasts longer than 24 hours do what your health care provider 

  • You will likely stay in the hospital overnight or longer.

  • Care for the catheter and drainage site as directed.

  • Talk with your health care provider about how long the catheter will need to stay in place.

What are the risks and complications of biliary drainage?

  • Infection inside your body or at the insertion site

  • Bleeding at the insertion site

  • Leakage of bile into the abdomen

  • Liver injury and bleeding inside the liver. You may need a blood transfusion for this.

  • Problems because of contrast medium. These include allergic reaction or kidney damage.

  • Exposure to generally safe and low levels of X-ray radiation.  This exposure is felt to be very low and usually this risk is far outweighed by the benefits of the study.