BILIARY DRAINAGE

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PREOP:

  • Need antibiotics (zosyn, unasyn, levofloxacin + flagyl)

ESTIMATED TIME: 60MIN

 

Equipment Always Necessary:

  • Neph set
  • Echo tip needle
  • 5Fr 40cm KMP
  • Bentson wire
  • 180cm amplatz wire
  • 10.5Fr Biliary drain
  • 10 Fr dilator

PREP:

  • POSITION: Supine
  • drape: CHEST-BREAST DRAPE (found in central supply)
  • Scout View
  • Wide prep. Entire upper abdomen from xyphoid to umbilicus should be include both RIGHT and LEFT SIDES.
  • NEED US
  • The right side needs to be prepped all the way to the table

 

Stand by Equipment

  • 180cm angled glidewire
  • 6FR sheath
  • Extra Echo tip needles and extra Chiba needles
  • Several extra mandril wires readly available
  • Nitrex 0.018 wire
  • Have a few needles in the room. Also have a few extras 22g x 15cm Chibas.

 

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Dressing:

  • 4X4 and tegader. 
  • Please do not use Stat lock !!!!

PEARLS:

  • If the left duct is visible by US, we prefer that for initial access. 
  • If biopsy is planned, may need brush which is available in Endoscopy (see pic)