Discharge Instructions: Biliary Catheter

You are going home with a biliary catheter in place. This is a small, flexible rubber tube placed into the common bile duct. This passageway allows bile, a thick yellow or green fluid, to flow from the gallbladder and liver to the small intestine. The catheter can drain the bile either inside your body or into a bag outside your body. This sheet provides instructions for care after the procedure and care for your catheter.

Home care

• Do not take aspirin, ibuprofen, Motrin, Aleve, Goody's or BC's for 3 days after the procedure.
• If you received anesthesia or any type of sedation, follow these instructions for the first 24 hours after the procedure.
• Do not drive or operate heavy machinery. You will need someone else to drive you home.
• Do not drink any alcohol.
• Do not make any important decisions or sign legal documents.
• Have someone stay with you.

Caring for your Biliary Catheter

• Empty your drainage bag before it gets full.
• Do not take baths, soak in a hot tub, or go swimming.
• Shower as needed, but cover the tube and the area around it with plastic wrap taped in place.
• Flush the catheter 1-2 times per day.  Follow the steps below.
• Change your dressing (split gauze sponges, gauze, and tape) every 3 days, or more often if it becomes wet, dirty, or loose. Follow the steps below.
• Keep the drainage bag attached to your leg above your knee.

Flushing the catheter

You will flush your catheter with 10mL of normal saline 1- 2 times per day unless your provider asks you flush your catheter more often.

Gather your supplies

• 1 (10 mL) prefilled normal saline syringe or 1 syringe and 10mL of normal saline

• 1 alcohol wipe

To flush

• Wash your hands with soap and water.
• Fill a syringe with 10mL of saline or use a 10mL prefilled syringe.
• Remove the cap from the syringe using a twisting motion. With the cap off, remove the air from the syringe by holding the syringe open-side up and pushing the plunger slowly until the normal saline is at the top. Lay the syringe on the table. Do not allow the tip of the syringe to touch anything.
• Clean the blue cap (needleless connector) on the stopcock with an alcohol wipe for 15 to 30 seconds.
• Attach the 10mL syringe of saline to the blue cap. (see Figure 1) Hold the connector while you push and turn the syringe clockwise to lock it into position.
• Turn the stopcock toward the drainage bag (see Figure 2).
• Push the plunger of the syringe to push 1/3 of the normal saline into the catheter, and then pause. Push in another 1/3 of the normal saline, and pause again.  Push in the rest of the normal saline into the catheter. Never pull back on the plunger. Always push forward.
• Remove the empty syringe by turning the syringe counterclockwise.  You can throw it away in your regular trash.

• Turn the stopcock back to the direction of the blue cap (see Figure 3). You will probably see fluid drain into the bag.

Figure 1

Figure 2

Figure 3

Changing the dressing

You will change the dressing every 3 days following these steps.

Gather your supplies

• Q-tips
• Hydrogen Peroxide and sterile water mixture (Mix 1/2 hydrogen peroxide with 1/2 sterile water in a small cup.)
• A clean drainage bag and tubing
• 4" x 4" gauze pads
• Tegaderm clear plastic bandage
• Tape
• Foam anchoring device
• Plastic bag to throw away supplies

Remove the old dressing and check for problems

• Wash your hands thoroughly using mild soap and warm water.
• Remove the old dressing. Be careful not to pull on the tube.  Never use scissors around or near your catheter.

• Check the skin around the exit site. (This is the place where the catheter leaves the body.)

  • Look for signs of infection such as swelling, bleeding, irritation, unusual or smelly drainage.

  • Look for any sores next to the exit site. Sores can form around the exit site if there is too much pressure from the tube on the skin.

Clean the site and change the dressing 

• Wash your hands again using mild soap and warm water.
• Clean around the exit site.
  • Dip the Q-tip in the hydrogen peroxide and sterile water mixture. 
  • Use a circular motion to clean the skin.  Start at the exit site and move outward.
  • Use a clean Q-tip each time.  Do not dip a used Q-tip in the hydrogen peroxide and sterile water mixture.
• Fold a 4" x 4" gauze pad in half. Slide the gauze under the tube where the catheter enters your body. Fold the gauze over the tube. See Figure 4.
• Cover the gauze with a Tegaderm clear plastic bandage. See Figure 5.

Figure 4

Figure 5

Changing the drainage bag

You will change the drainage bag 1 time a week, or more often as needed.

Change the drainage bag

• Wash your hands again using mild soap and warm water.
• Attach the clean drainage bag to your leg above your knee. See Figure 6.
• Stick the foam anchoring device to your skin next to the stop cock. Place the tube in the center of the foam anchoring device. Fold the blue tabs up and stick together.  The foam anchoring device helps the catheter stay in place. See Figure 7.
• Always keep the catheter and tubing straight.  This will help with draining.
• Clean the drainage bag by rinsing it out with soap and water. Allow it to air-dry. Keep two drainage bags on hand. One should be clean and ready for use at all times.

Figure 6	Figure 7

Follow-Up

Keep all follow-up appointments.

When to Call Your Doctor

Call your doctor right away if you have any of the following:

• Plastic ring that comes away from the skin
• Catheter that becomes kinked and can not be straightened
• Catheter that stops draining into the bag
• Catheter falls out
• Skin rash
• Blood or pus leaking around the catheter site
• Sudden pain
• Fever of 100.4°F (38°C) or higher, or chills