PROCEDURES:Â Â
- Cholangiography through existing drainage catheter
- Biliary drain removal
INDICATION:Â Â Â Â
OPERATORS: Â John Doe, MD (Attending)/Jane Doe, MD (Fellow) Â Â Â
MEDICATIONS: Versed   mg IV, Fentanyl   mcg IV, Zosyn 4.5 mg IV
CATHETER: Existing 8 French Amplatz anchor        Â
   Â
PROCEDURE:Â
The risks, benefits and alternatives to the procedure and sedation were explained to the  , and written informed consent obtained.Â
The right abdomen was prepped and draped in the usual sterile fashion. 2% Lidocaine was injected in the subcutaneous and deep soft tissues around the existing drain. Injection of contrast into the existing 8 French biliary drain was performed with imaging over the right upper quadrant. The Amplatz anchor was unlocked and removed. Sterile dressing was applied.
The patient tolerated the procedure well and was discharged from the angiography suite in satisfactory condition.
FINDINGS:
Normal appearance to both the extrahepatic and intrahepatic biliary systems without evidence of stricture, filling defects or extrinsic masses. Free spillage of contrast into duodenum was observed.Â
IMPRESSION:
- Successful cholangiography through existing biliary drainage catheters with removal of existing biliary drainage catheter.
Frequently Asked Questions
A cholangiogram is an imaging test used to visualize the bile ducts. It helps detect any blockages, stones, or other abnormalities within the biliary system. This procedure is often performed when a patient has symptoms like jaundice or abdominal pain, or to evaluate the bile ducts before or after surgery.
How is a biliary drain removed?
The removal of a biliary drain involves unlocking and gently extracting the catheter, which is typically anchored in place. The area is first numbed with a local anesthetic, such as Lidocaine, to minimize discomfort. After removal, a sterile dressing is applied to the site to prevent infection.
What are the risks associated with a cholangiogram?
Risks of a cholangiogram include infection, bleeding, or damage to the bile ducts. There may also be risks related to the contrast dye used, such as allergic reactions. However, these complications are rare, and the procedure is generally considered safe when performed by experienced medical professionals.
What medications are typically used during a cholangiogram?
During a cholangiogram, sedatives like Versed (Midazolam) and pain relievers such as Fentanyl are commonly used to help the patient relax and minimize discomfort. Antibiotics like Zosyn may also be administered to prevent infection.
What preparation is needed for a cholangiogram?
Patients are usually advised to refrain from eating or drinking several hours before the procedure. They should inform their doctor about any medications they are taking, especially blood thinners, as these might need to be paused. Written informed consent is also required before the procedure.
What does a normal cholangiogram show?
A normal cholangiogram reveals a clear and unobstructed view of both the extrahepatic and intrahepatic bile ducts with no signs of strictures, stones, or extrinsic masses. It should also show the free flow of contrast into the duodenum, indicating no blockages.
A cholangiogram is typically performed by an interventional radiologist or a surgeon with specialized training. The procedure is often conducted with the assistance of a medical fellow or resident under the supervision of an attending physician.
How long does it take to recover after a biliary drain removal?
Recovery after biliary drain removal is usually quick, with most patients experiencing minimal discomfort. They are often discharged the same day and can resume normal activities shortly after, although specific recovery times can vary based on individual health conditions.