Re: Liver Catheterization with drainage bag

[Guest guest]

anyone else had had a liver catheterization done and how it worked out for them.

Is that the same thing as a t-tube?

Jeff

[Guest guest]

Yes it is.

>

>

> In a message dated 12/31/2006 6:16:46 A.M. Eastern Standard Time,

> swandesigns02@... writes:

>

> anyone else had had a liver catheterization done

> and how it worked out for them.

>

>

> Is that the same thing as a t-tube?

>

> Jeff

>

[Guest guest]

I have had a PTC drainage tube in place for the last 3 years to keep

my bile duct open. It has worked well to keep bile flowing past a

stricture that formed at the junction of my bile ducts with the

roux-en-y loop, which was put in place when I had my transplant in

1998. Deb in Va has had 3 PTC drains placed temporarily to keep her

ducts open in the months after her transplant. I don't recall anyone

reporting PTC tube placements pre-transplant in this group, but have

seen illustration of its use pre-transplant at

http://hopkins-gi.nts.jhu.edu/pages/latin/templates/ (in the Biliary

Tract section of the " Digestive Disease Library " - under " Therapy " for

primary sclerosing cholangitis).

I think you are confusing t-tubes, which are usually placed surgically

to allow healing of a bile duct junction, with percutaneous

transhepatic cholangiography (PTC), which can include palliative

biliary dilation and/or stent/drain placement. See

http://www.surgery.usc.edu/divisions/hep/patientguide/t-tube.html and

http://patienteducation.upmc.com/Pdf/CholangBiliDrain.pdf.

Tim R, ltx 1998, recurrent PSC 2002

> > In a message dated 12/31/2006 6:16:46 A.M. Eastern Standard Time,

> > swandesigns02@ writes:

> >

> > anyone else had had a liver catheterization done

> > and how it worked out for them.

> >

> --- In , Jeffsullivan@ asked:

> > Is that the same thing as a t-tube?

--- In , " swandesigns02 " replied:

>

> Yes it is.

[Guest guest]

Yes, I think I am confused about what tube is what! Maybe what I had was a PTC? I would like to figure this out. When I was first diagnosed with PSC in 1989, I had what was then explained to me as a T-tube placed in my primary bile duct to open a severe stricture. Within a week of the tube placement and draining nearly black crud out of my liver into a bag I had remarkable improvement of all my symptoms. Once the bile was running clear the drainage bag was removed and the exterior portion of tube tied off. My surgeon in Lexington, KY wanted me to keep the tube in place for a year...I lasted a little more than 6 months before things began to deteriorate again. After much frustration I sought out Dr. Gores at Mayo. There, in the process of using the t-tube to do a cholangiogram (which caused an almost immediate fever,chills, and nausea) I found out the tube had become hardened and clogged with debris because no one ever mentioned that it should have been flushed out with saline periodically (I like to think there's been some improvement in current protocol as a result of my suffering. ha)!

From there I went under a fluoroscope (for what seemed like and eternity) while they tried to get the darn thing to fold on itself and come out...no luck. Went for the same procedure the next day with surgical staff in waiting incase the bile duct tore apart in the effort to remove the t-tube. By no small feat, Dr. Gores was able to manipulate the tube until it did finally come out. Things improved again after that for a while. After many years of relatively slow deterioration I am now at the point where my current physician says my bile ducts have strictured beyond being able to do any dilatation or stenting. And oddly enough I have been contemplated revisiting Dr. Gores again...over 17 years later.

Jeff in FL

I have had a PTC drainage tube in place for the last 3 years to keepmy bile duct open. It has worked well to keep bile flowing past astricture that formed at the junction of my bile ducts with theroux-en-y loop, which was put in place when I had my transplant in1998. Deb in Va has had 3 PTC drains placed temporarily to keep herducts open in the months after her transplant. I don't recall anyonereporting PTC tube placements pre-transplant in this group, but haveseen illustration of its use pre-transplant athttp://hopkins-gi.nts.jhu.edu/pages/latin/templates/ (in the BiliaryTract section of the "Digestive Disease Library" - under "Therapy" forprimary sclerosing cholangitis).I think you are confusing t-tubes, which are usually placed surgicallyto allow healing of a bile duct junction, with percutaneoustranshepatic cholangiography (PTC), which can include palliativebiliary dilation and/or stent/drain placement. Seehttp://www.surgery.usc.edu/divisions/hep/patientguide/t-tube.html andhttp://patienteducation.upmc.com/Pdf/CholangBiliDrain.pdf.Tim R, ltx 1998, recurrent PSC 2002> > In a message dated 12/31/2006 6:16:46 A.M. Eastern Standard Time, > > swandesigns02@ writes:> > > > anyone else had had a liver catheterization done > > and how it worked out for them. > > > --- In , Jeffsullivan@ asked:> > Is that the same thing as a t-tube? --- In , "swandesigns02" replied:>> Yes it is.

[Guest guest]

We may both be confused and uncertain about what you had implanted to

open your stricture. I still think it was most likely a transhepatic

stent placed via a PTC procedure. That is what I currently have and I

flush it daily with a saline solution to help prevent clogging - even

so it needs to be changed every 8 weeks or so. When it was first put

in, a bag was attached to drain externally, but after a week it was

capped off and since then I haven't had external drainage except on

rare occasions.

Right after my transplant I had a t-tube in place for 3 months. For

the first 2 weeks it was attached to collection bag and I dutifully

measured how much bile came out. Then it was capped off and spent the

next 2 1/2 months coiled up and taped to my abdomen, held in place by

a stitch to keep it from moving in or out. It never was flushed with

saline. When the time came to remove it the doctor (an intern, I

believe) just clipped the stitch and told me to hold my breath while

he pulled it out.

The PTC tube changing is more complicated since a sterile field is

needed for putting in the new tube. Don't want to insert too many

germs into the abdominal cavity! But other than being well scrubbed

and draped, the change goes pretty much the same - a guide wire is

placed beside the old tube, which is pulled out and the new one is

slid in following the track of the guide wire. I get antibiotics, but

no sedation for the procedure, which only takes a few minutes once

everything is set up.

Regards,

Tim R, ltx 1998, recurrent PSC 2002

> Yes, I think I am confused about what tube is what! Maybe what I

had was a

> PTC? I would like to figure this out. When I was first diagnosed

with PSC

> in 1989, I had what was then explained to me as a T-tube placed in

my primary

> bile duct to open a severe stricture.