47537 Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological s

Name of the Procedure:

• Removal of Biliary Drainage Catheter, Percutaneous
• Technical term: Percutaneous removal of biliary drainage catheter under fluoroscopic guidance with concurrent indwelling biliary stents and diagnostic cholangiography

Summary

This procedure involves the removal of a biliary drainage catheter, which is a tube placed to drain bile. It is done through the skin using imaging guidance like fluoroscopy to ensure accuracy. The procedure may also involve checking the bile ducts via cholangiography and may include the presence of biliary stents.

Purpose

• Medical Condition: This procedure is used to treat issues like bile duct obstructions, bile leaks, or infections.
• Goals: To restore normal bile flow, prevent or treat infections, and reduce symptoms like jaundice and pain.

Indications

• Persistent bile duct obstructions or strictures.
• Infections requiring removal of the drainage catheter.
• Resolution or significant improvement of bile duct conditions.
• Patient recovery milestones indicating the catheter is no longer necessary.

Preparation

• Fasting for 6-8 hours before the procedure.
• Adjustment of blood-thinning medications as advised by the doctor.
• Pre-procedure diagnostic tests such as blood work or imaging studies to plan the procedure.

Procedure Description

1. Patient is positioned appropriately and prepped for the procedure.
2. Local anesthesia or moderate sedation is administered to ensure patient comfort.
3. Using fluoroscopic imaging, the physician identifies the bile duct and the catheter.
4. The catheter is carefully removed from the bile duct.
5. Diagnostic cholangiography may be performed to visualize the bile ducts.
6. Any necessary adjustments or additional steps, like the placement or correction of biliary stents, are taken.
7. The insertion site is cleaned and dressed.

Duration

Typically 30-60 minutes.

Setting

• Hospital radiology suite or an outpatient clinic with appropriate imaging facilities.

Personnel

• Interventional radiologist.
• Radiology technologist.
• Nurse or medical assistant.
• Anesthesiologist or nurse anesthetist (if sedation is used).

Risks and Complications

• Common risks: Infection at the insertion site, bleeding, minor pain or discomfort.
• Rare complications: Injury to the bile duct, significant bleeding, adverse reaction to contrast dye, complications from sedation.

Benefits

• Relief from symptoms associated with bile duct obstruction.
• Prevention or treatment of infections.
• Improved bile flow and digestion.

Recovery

• Short observation period post-procedure.
• Instructions for wound care and signs of infections to watch for.
• Typically, patients can return to normal activities within a day or two.
• Follow-up appointments to monitor recovery and bile duct function.

Alternatives

• Endoscopic removal of the catheter.
• Surgical removal of the catheter.
• Medication management for symptoms if catheter removal is not immediately required.
• Each alternative has its own risk and benefit profile which should be discussed with your doctor.

Patient Experience

• Mild discomfort during local anesthesia administration.
• Sensation of pressure or pulling during catheter removal.
• Post-procedure soreness at the insertion site.
• Pain management with over-the-counter pain relievers, if necessary.
• Comfort measures include resting and applying ice packs to the procedure site if advised.