Discharge Instructions for Cholecystostomy (gallbladder) Drain

 

What is a cholecystostomy (gallbladder) drain?

A cholecystostomy drain allows bile to flow out from a blocked gallbladder into a collection bag outside the body. Bile is a liquid made by the liver. It helps digest fats. Tumors or gallstones can block the flow of bile out of the gallbladder and cause yellowing of the skin (jaundice) or an infection of your liver.

The drain is a thin plastic tube (catheter) that your doctor places in the gallbladder. From there the tube passes out through a drain site on your skin and into a collection bag. The amount of bile that drains varies from person to person but should be about the same each day.

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

How long you have the drain in place depends on what caused the problem with your gallbladder. Your doctor will discuss this with you.

 

How can you care for yourself at home?

This care sheet gives you a general idea about how long it will take to recover. Please remember, each person recovers at a different speed. 

 

Recovering from Anesthesia

You had local anesthesia (a shot to numb the area). You may feel some pain and discomfort as it wears off. You may have also gotten a sedative to help you relax as well as pain medication to ease pain. It is usually given in a vein (by IV). Common side effects from sedation include:

• Feeling sleepy. Your doctors and nurses will make sure you are not too sleepy to go home.
• Nausea and vomiting. This usually does not last long. It can be treated with over-the-counter medication. Read and follow all instructions on label.

 

Recovery Instructions

Pain/Discomfort:  

• You may have mild to moderate pain where the tubing enters your skin (insertion site). This is normal and expected. It will improve over the next few days. Our goal is to treat your pain safely. Sometimes, pain may not go away completely.  We will do our best to help you feel better.
• Acetaminophen (Tylenol®) is an over-the-counter medication you may take if needed for pain. If you are unable to take acetaminophen (Tylenol) due to a medical condition like liver disease, ask your doctor for recommendations. Be safe with medicines. Read and follow all instructions on label. 

Diet:

• You can eat and drink fluids as tolerated, unless your doctor gives you other instructions.

 

Activity:

• Rest when you feel tired, especially for the first 24 hours. Getting enough sleep will help you recover.
• You can go back to normal activities tomorrow, including driving. However, avoid strenuous activities like heavy lifting while you have the tube.
• Avoid positions that bend or kink your tubing.
• Wear loose clothing that does not rub or pull on the tube. Be careful not to pull on it when getting dressed.
• Do not take a bath or swim while you have the drain. 
• You may shower 24 hours after your procedure. When you shower, cover the area with waterproof material, such as plastic wrap. Try to keep the area dry.

 

Caring for the insertion site: 

You have a bandage covering the insertion site (where the drain or tubing enters your skin). Change the bandage every 3 days and any time it is damp, loose, or dirty.

• To change the bandage: 
  • Wash your hands with soap and water.
  • Take off the old bandage by holding the drain in one hand and pulling the tape with your other hand.
  • Gently clean the site and the skin around it with soap and water. You can use gauze or a cotton swab if needed. Do not use hydrogen peroxide or alcohol, which may delay healing.
  • Gently pat dry with clean gauze. Cut a slit in a piece of gauze and fit it around the drain site. Secure the gauze and tubing with tape.
• Do not use any lotion or powder near the drain site.
• You may have a small amount of bruising at the drain site. This is normal and should go away over the next several days.

 

Caring for the tubing:

• Clamp or tie off the tubing if it breaks. Then, go see a doctor as soon as possible.
• Never use scissors, knives, pins, or other sharp objects near the tubing.

 

Flushing the catheter:

Flush the catheter at least once each day. You will need one 5mL or larger saline flush.

• Wash your hands with soap and water.
• Take the syringe out of the wrapper. 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. Squirt the extra saline out so you are left with 5 mL of saline in the syringe. Lay the syringe on the table. Do not allow the tip of the syringe to touch anything.
• Disconnect the drainage bag from the catheter/tubing.
• Insert tip of syringe into catheter and twist until connected.
• Push the plunger of the syringe to push 1/3 of the saline into the catheter. Then pause. Push in another 1/3 of the saline. Pause again. Then push in the rest of the saline into the catheter. Never pull back on the plunger. Always push forward.
• If you have any of the following while flushing, do not try to put in any more saline. Stop and call your doctor’s office: 
  • Pain
  • Feel resistance
  • See leaking around the catheter
• When the syringe is empty, turn it counterclockwise to remove it. You can throw it away in your regular trash. Connect the catheter to the drainage bag. You will probably see fluid drain into the bag.

 

Caring for the drainage bag

How often you empty the bag depends on how much fluid is draining. Empty the bag when it is half-full or at least once a day.

• To empty the drain:
  • Wash your hands with soap and water.
  • Open the drainage port at the bottom of the bag.
  • Empty the contents of the bag into the toilet. However, if your doctor asked you to keep a log of how much bile collects, empty it into a measuring cup.
  • Clean the drainage port with soap and water and close it.
  • Wash your hands again with soap and water.
• If the bag breaks or tears, replace it as soon as possible.
• Secure the drain to your body to prevent pulling or dangling. Most people secure the bag to clothing using a safety pin. Keep the bag lower than the drain site. This way, the fluid drains down into the bag.

  

Follow-Up Care

Follow-up care is a key part of your treatment and safety.

• Test results may take up to 5 business days to come back. If you have not heard from your referring provider by that time, please contact them for results.

• Be sure to make and go to all appointments. Call your doctor if you are having problems.

• It is also a good idea to know your test results and keep an up-to-date list of the medications you take.

 

When should you call for help? Call 911 anytime you think you may need emergency care. For example, call if: You pass out (lose consciousness)   Call your doctor or seek medical care right away if: There is a new or increasing yellow tint to your skin or the whites of your eyes. You have pale-colored stools and/or dark urine and itching. You see a sudden change in the color or smell of the drainage. The tubing looks like it has come out from the skin. You have very bad pain in the area. You have nausea or vomiting that does not get better with over the counter medications. You have signs of infection such as: Increased pain, swelling, warmth, or redness around the puncture site Pus draining or red streaks leading from the area A fever over 101.5̊ F (38°C) that does not go down with over-the-counter medications and lasts longer than 24 hours, chills, or body aches

 

You can speak to a provider in Interventional Radiology:

• Monday-Friday 9AM-5PM, call 212-263-5898.
• Weekdays after 5PM or weekends, call 212-263-5230 and ask the front desk to contact the Vascular Interventional Radiologist on-call.

 

Watch closely for changes in your health, and be sure to contact your doctor if:

• You see a lot of fluid around the drain or soaking the bandage.
• Drainage stops coming out of the tube.
• You do not get better as expected.

 

© NYU Langone Health. All rights reserved. Reviewed for health literacy. This information is not intended as a substitute for professional medical care. Always follow your health care provider's instructions.