Discharge Instructions: Biliary Catheter
You are going home with a biliary catheter in place. This is a small, flexible tube placed into the common bile duct. It is used when this duct becomes blocked. The catheter allows a fluid (bile) to flow from the gallbladder and liver to the small intestine. The catheter can drain the bile inside your body. Or it can drain the bile into a bag outside your body. Your provider talked with you about how long the biliary catheter will need to be in place. This sheet gives you general guidelines on caring for your catheter.
If you have an outside catheter:
Be sure to empty your catheter bag before it is completely full.
Don’t go swimming, take baths, or soak in a hot tub.
Shower as needed, but keep the tube and the area around it dry. Ask your healthcare provider about the best way to do this.
Change your dressing (split gauze sponges, gauze, and tape) every 3 days. Change it more often if it becomes wet, dirty, or loose.
Changing the dressing
Here are general guidelines for changing the dressing.
Gather your supplies:
A clean drainage bag
Nonstick gauze pads
Clear, waterproof bandages
Split gauze sponges
4-inch-by-4-inch gauze pads
Connecting tube and drainage bag, if needed
Plastic bag to dispose of supplies
Removing the old dressing
Wash your hands well using mild soap and warm water.
Remove the old dressing. Be careful not to pull on the drainage catheter. Keep the plastic ring against the skin.
Check the skin around the catheter. Look for any unusual redness, soreness, or drainage.
Wash your hands well again. Use soap and warm water.
Applying the dressing
Cut a round piece of nonstick gauze pad, slightly larger than the plastic ring. Cut a slit in the nonstick gauze pad so that it will fit around the catheter. Place the nonstick gauze pad under the blue disk.
Fold a new clear, waterproof bandage in half. Cut a hole in the center. The hole should be about the size of the nipple on the plastic ring. Put the catheter through this hole. Apply the clear, waterproof bandage to your skin. If the catheter is attached to a drainage bag, you must first disconnect the bag. Then slip the catheter through the clear, waterproof bandage.
Place 2 split gauze sponges around the catheter.
Fold a 4-by-4-inch gauze pad on each side of the catheter. You should be able to curl the catheter once without twisting (kinking) it. The catheter should rest on the gauze and not on your skin.
Cover the catheter with a 4-by-4-inch gauze pad. Use tape to hold the dressing in place.
Put a piece of tape below the dressing to hold the catheter. This will also act as a safety device.
Clean the external drainage bag by rinsing it out with soap and water. Allow it to air-dry well. You should have 2 drainage bags on hand. One should be clean and ready for use at all times.
Flushing the catheter
Always wash your hands well before working with your catheter.
Open the cap and wipe it clean with alcohol. Attach a syringe that is prefilled with normal saline. Do this by turning it clockwise until it is in the locked position. (Your provider will tell you what size syringes and how much normal saline to use.)
Using the plunger, slowly push down.
The saline should infuse easily. If you meet resistance, stop and call your home healthcare nurse or doctor.
Follow up with your healthcare provider, or as advised.
Keep all follow-up appointments. Your provider will need to check your tube once a month. Your provider will change it every 8 to 12 weeks.
When to call your provider
Call your healthcare provider right away if you have any of the following:
Plastic ring that comes away from the skin
Catheter that gets twisted and can’t be straightened
Catheter that stops draining into the bag
Catheter falls out
Blood or pus leaking around the catheter site
Fever of 100.4°F (38°C) or higher, or as advised by your healthcare provider
August 15, 2018
Quality Improvement Guidelines for Percutaneous Transhepatic Cholangiography, Biliary Drainage, and Percutaneous Cholecystostomy. Saad. J Vasc Interv Radiol. 2010, is. 21, pp. 789-95.
Adler, Liora C., MD,Fraser, Marianne, MSN, RN