Patient Name: ,
DOB: SEX:
Ordering Physician: ,
PROCEDURE:
- Cholangiogram through existing catheter
- Biliary catheter replacement
INDICATION:
DATE:
OPERATORS: John Doe, MD (Attending)/Jane Doe, MD (Fellow)
MEDICATIONS: Versed mg IV, fentanyl mcg IV, Zosyn 3.375 gm IV
CONTRAST: ml non-ionic contrast
FLUOROSCOPY TIME: minutes
CATHETER: French biliary drain
COMPLICATIONS: None
TECHNIQUE: The risks, benefits, and alternatives to the procedure and sedation were explained to the patient. The specific risk of sepsis was detailed and accepted. Written informed consent was obtained.
The existing catheter and surrounding soft tissues were prepped and draped in sterile fashion. Local anesthetic was injected at the catheter entry site.
Contrast was injected through the existing tube and cholangiographic images obtained.
A wire was negotiated through the catheter and into the small bowel. The catheter was removed over the wire, and a new catheter was placed. The pigtail was formed and locked in the _____. The tube was _____ . The catheter was secured to the skin with 2-0 Ethilon. The patient tolerated the procedure well without immediate complications.
FINDINGS: Comparison is made to a prior study dated _____ .
- Cholangiogram through the catheter demonstrates
- The new catheter is appropriately positioned with the distal tip in the ____and the proximal side hole in a peripheral bile duct.
IMPRESSION: Uneventful image guided replacement of a biliary catheter as described.
PLAN:
Frequently Asked Questions
What is a cholangiogram and why is it done?
A cholangiogram is an imaging test that uses X-rays to visualize the bile ducts. It's typically performed to assess blockages or abnormalities in the bile ducts, which can be caused by conditions such as gallstones or tumors. The procedure helps doctors determine the best course of treatment for biliary issues.
Biliary drain replacement involves removing an existing catheter and inserting a new one into the bile duct system. Under sterile conditions, a guide wire is inserted through the old catheter, which is then removed. A new catheter is placed over the wire, and its position is confirmed with imaging. This procedure helps ensure proper bile drainage.
What are the risks associated with a cholangiogram?
The main risks of a cholangiogram include infection, bleeding, and allergic reactions to the contrast dye used. There is also a specific risk of sepsis, a severe infection that can spread throughout the body. However, these risks are generally low, and the procedure is typically well-tolerated.
What medications are used during a biliary drain change?
During a biliary drain change, medications such as Versed (a sedative), fentanyl (a pain reliever), and Zosyn (an antibiotic) may be administered. Versed helps relax the patient, fentanyl manages pain, and Zosyn is given to prevent infection.
How should a patient prepare for a cholangiogram?
Patients should follow their healthcare provider's instructions, which may include fasting for several hours before the procedure. It's important to discuss any medications being taken, especially blood thinners, as they may need to be paused. Patients should also arrange for transportation home afterward due to sedation effects.
What should a patient expect after a biliary catheter replacement?
After a biliary catheter replacement, patients may experience mild discomfort at the insertion site, which can be managed with pain relief medications. They should monitor the site for signs of infection, such as redness or swelling, and follow post-procedure care instructions. Typically, patients can resume normal activities shortly after the procedure.
Why is contrast dye used in a cholangiogram?
Contrast dye is used in a cholangiogram to enhance the visibility of the bile ducts during X-ray imaging. It helps delineate the ducts' structure, allowing for the identification of blockages or abnormalities. The dye is usually non-ionic, reducing the risk of allergic reactions.