What is a biliary drain?

A biliary drain allows bile to flow out from a blocked bile duct into a collection bag outside the body. Bile is a liquid made by the liver. It helps digest fats. Blocked or narrowed bile ducts can stop the flow of bile and cause yellowing of the skin (jaundice) or an infection of the liver.

The drain is a thin plastic tube (catheter) that the doctor places in the bile duct. From there the tube passes out through a drain site on your skin and into a collection bag. The bag may be attached to a belt or pinned to your clothing. Up to 1 L (4 cups) of bile will collect in the bag each day. The amount should be fairly constant from day to day.

The bile that comes out of the drain may look bloody at first, but it will soon change to its normal yellow-green colour.

How long the drain stays in place depends on what caused the problem with your bile duct. If a biliary stent is placed, the drain may be capped but stay in place to make sure the stent is working. If the drain is to stay in place when you go home, you'll get instructions on how to care for it. Your doctor will discuss this with you.

How can you care for your biliary drain at home?

Your doctor or nurse can answer any questions you have about caring for your drain or bag. You may need help to care for your drain. Your healthcare team will work with you to make sure you have the support you need.

1. Learn to change the bandage.

   You may have a bandage on your skin where the tube comes out of your body. Your doctor or nurse will tell you how often to change it. To change the bandage:

   1. Wash your hands with soap and water.
   2. Take off the bandage from around the drain.
   3. Use gauze or a cotton swab to clean the drain site and the skin around it with soap and water.
   4. When the site is dry, you can put on a new bandage.

      First, with clean scissors cut a slit in the bandage, and then fit it around the drain site. Make sure the bandage will stay in place. You can use a small amount of tape.

2. Keep the tube clear.

   To clear the tube, flush it with sterile saline. Your doctor or nurse will tell you how and when to do this.

3. Empty the bag as needed.

   Empty the bile from your bag when it's about 2/3 full, or at least once a day.

   1. Wash your hands with soap and water.
   2. If your doctor requested it, make a note of the amount of bile in the bag.
   3. Open the drainage port at the bottom of the bag.
   4. Empty the contents of the bag into the toilet.
   5. Clean the drainage port with soap and water, and close it.
   6. Wash your hands again with soap and water.

If the bag breaks or tears, replace it as soon as possible.

When should you call for help?

Call your doctor or Health Link at 811 now or seek immediate medical care if:

• You have symptoms of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the drain site.
  • Pus draining from the drain site.
  • A fever.

• There is a new or increasing yellow tint to your skin or the whites of your eyes.
• You see a sudden change in the colour or smell of the drainage.
• The tube is coming loose at the drain site.
• You have new or worse belly pain.
• You have a fever.
• You are vomiting.
• You cannot pass stools or gas.
• You have new or worse nausea or vomiting.

Watch closely for changes in your health, and be sure to contact your doctor or Health Link at 811 if:

• Drainage stops coming out of the tube or starts leaking around it.
• You do not get better as expected.