The subject of this short video is
the Percutaneous Transhepatic Biliary Drain. The tube and the medical procedure
to implant it go by a number of names and acronyms. For simplicity, we’re going to call it
a biliary drain. So what is a biliary drain
and why would you need one? A normally functioning digestive system
is responsible for breaking down and absorbing nutrients
into your bloodstream. Your liver produces bile salts
that break down the fats entering your small intestine. When your bile ducts
have blockages from cancer, the bile salts begin to build up
in your liver and blood. You may experience pain and fever,
and symptoms of jaundice: yellowing of the eyes and skin,
dark urine and pale stools. Fluids may accumulate in your abdomen. This is a very serious condition,
and if the blockage is not corrected, it can lead to a life threatening infection,
or even liver failure. One way to remove the bile
or other secretions from your body is to insert a biliary drainage tube. An Interventional Radiologist
will perform the procedure using local anaesthetic. Guided by x-ray or ultrasound,
the radiologist inserts a needle through the liver,
directly into your bile duct. A guide wire placed through the needle
will help to direct and position the drainage tube
to the desired location. When the procedure is complete,
the tube will allow bile to drain externally to a bile bag. If good internal drainage
can be achieved to your small intestine, a bile bag may not be necessary. In this case, a low profile device
can be applied to the external end, making the tube comfortable and discreet. If the biliary drainage tube is successful
and the obstruction is relieved, your liver function will improve
and you will feel better. Your oncologist will be able to inform you
if you have improved enough to proceed with further treatments
such as chemotherapy, radiation, and occasionally, surgery. This type of drainage tube can also
be very helpful in relieving obstruction arising from cancers
of the pancreas or small bowel. You, your home care nurses
and the Interventional Radiology Team will work together
to keep your biliary drain working well and free from infection. There are a few things
you’ll need to look out for. Occasionally fluid can leak out
around the tube. This is generally not serious
and can be addressed with gauze or dressing. Occasionally the external drainage tube
becomes blocked and flow to the bile bag stops. This may result in internal pressure
or pain near the liver. You must consult your doctor immediately. If the site looks or feels infected,
or if you develop a fever, you must also
consult your doctor immediately. To learn more about
day-to-day care of your liver drain, consult your Doctor
or a member of our care team.

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