A biliary drain is a small rubber catheter that is placed through the abdominal wall and into the liver.  The drain enters into a bile duct within the liver (called the biliary tree), and it courses through the common bile duct, with the tip ending in the small bowel.  The common bile duct has a natural connection to the small bowel, called the ampulla, the catheter will simply be passed through this natural connection.  The purpose of the catheter is to drain a biliary tree that is obstructed, most commonly by a stone, stricture or tumor.  The biliary catheter is also used to treat a leaking bile duct, which usually occurs as a complication of surgery.

The catheter has many holes so that the bile can enter into the portion of the catheter within the biliary tree, pass through the catheter and eventually into the small bowel. 
The portion of the catheter that is outside of the body may be capped, or may drain to a bag.  If the catheter is capped all of the bile will be draining into the small bowel.  If the catheter is connected to a bag the bile will drain both into the bag and into the small bowel.  After placement the catheter is frequently open to a bag for 7-10 days, then capped.  When bile passes into the bag it will be a thick dark-yellowish fluid.  Occasionally the fluid will be blood-tinged for several days following the procedure.  Each patient has a unique treatment plan based on the cause of biliary obstruction (or leak) and how well the catheter relives the obstruction, which is determined by obtaining blood draws approximately once a week.  Detailed instructions about when and how to cap your catheter will be given to you by your doctor.

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