choleic

choleic /cho·le·ic/ (ko-le´ik) biliary.

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cho·le·ic (k-lk)

adj.

Variant of cholic.

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choleic

[kōlē′ik]

pertaining to bile.

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biliary [bil´e-ar″e]

pertaining to the bile, to the bile ducts, or to the gallbladder.

biliary catheter (biliary decompression catheter) a catheter inserted via a skin incision through the liver and common bile duct into the duodenum. Its purpose is to provide for drainage of bile past obstructed bile ducts and into the small intestine, where it aids digestion. Called also transhepatic biliary catheter.

Immediately after insertion, the proximal end of the catheter is attached to a drainage bag into which the bile temporarily flows. This permits observation of the catheter and amount of bile output. A three-way stopcock between catheter and drainage bag facilitates irrigation and maintains a closed drainage system to minimize contamination. After a few days the end of the catheter is capped with an adapter. The bile then flows interiorly through the catheter's ports above and below the obstruction.

Patient Care. While the catheter is attached to the drainage system the patient is monitored carefully for signs of obstruction and the drainage is observed. Bleeding from the catheter can occur internally or externally. Hence the drainage is observed for excessive amounts of blood and the vital signs checked every 15 to 30 minutes for 2 hours, then every 4 hours for 8 to 16 hours or longer. The dressing and area around the insertion site are checked for bile leakage, which indicates that the catheter either is dislodged or is obstructed by debris. Fever and chills can indicate biliary sepsis.

After the drainage bag is removed and the catheter tip capped with an adapter, it is flushed once a day to ensure patency. The adjacent skin is observed for signs of irritation from bile leakage and the insertion site is assessed for signs of infection.

During the time observations, irrigations, and catheter care are being done, the patient and family are given instruction so that these procedures can be continued at home. They also are taught signs of complications that might arise if the catheter is not working as it should and the importance of getting help from a health care provider if the signs of complications appear.

Within about 2 weeks liver function improves and jaundice abates. Stool and urine color should return to normal, pruritus should be relieved, and the patient should be more comfortable. The biliary catheter does not cure the biliary obstruction. It is an alternative to surgical intervention when the patient is too ill to withstand surgery or has a terminal hepatic malignancy obstructing the flow of bile.

biliary drainage test an examination of the contents of the duodenum at the site where the common bile duct empties into it. The test is used when other, more conventional diagnostic tests for gallbladder disease reveal no pathology but the patient's symptoms persist. Specimens are collected via the Rehfuss tube and examined for leukocytes, cholesterol crystals, and parasites.

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choleic

pertaining to the bile.