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Bile Drain - Is it good for you to be on it too long?

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puternut | 23:26 Wed 10th Aug 2011 | Body & Soul
14 Answers
My wife has had problems with her intestine following gall-bladder removal 16 days ago.

The series of events is complicated so I wont go into it but the upshot she has been fitted with a T-drain in her intestine to syphon off the bile.

Myself, my wife and some others are just wondering if this bile is being drained off are they compromising her intestinal system as regards normal function? I mean if they are depriving it of up to a litre of bile a day can her digestive system cope?

The surgeon/registrar say the amount deing drained off should slow down - and I believe it is - but at a slower rate than they would like.
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The T-drain is not likely to be in the intestine, but in the common bile duct which bypasses the problem allowing it to heal.

I do not know where or what the problem is, but it sounds as though the common bile duct has been damaged at it's entrance to the duodenum (intestine).Just a guess but a recognized problem.

Your wife will have a drip and for the period of time that the T-tube is in place, the normal intestinal functions will not be compromised.

Keep us informed.
Just had another thought...I have seen patients go home with a T-tube in place and remain in place for a matter of months. This may not apply to your wife, but just to reassure you that she will come to no harm with this sort of drainage in situ.
puter, by any chance did your wife keyhole surgery for removel of gall bladder. and now has complications ?
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Many thanks Sqad for your informative reply - I am always grateful if you come 'on board'.

Yes anne she did have keyhole surgery. But I feel that the gall stones they had seen in there were not the only cause of a problem my wife has had for over 10 years of occasional severe stomach pains for - until now - unexplained reasons. The fact it was keyhole was only an attempt to reduce recovery time as surgeon told her he would attempt it but if unsuccessful would revert back to 'standard' full cut surgery

The surgery was seen as different at my local hospital as it was the first gall-bladder removal on somebody who has previously had a gastric bypass done (3 years and 15 stone ago). This has not caused any major problems for the surgeon other than if they cannot do an endoscopy down the throat because this now bypasses the 'plumbing' they would generally observe post op. I understand the bypass connects near to the pancreas further down the intestine.

During the original surgery they did report an 'enlarged' duct but stapled it smaller - does that sound right Sqad <Grin>

Following a sucessful removal my wife was in severe pain almost immediately and so 3 days after surgery they decided to go in again and thats when the T-drain was fitted.

Another problem seems to be that when they were doing this they noted a narrowing of the duct below the drain. All they could say is that in a duct they expect to be about 10mm diameter they could not pass a 3mm camera down through the narrowing.

They called for an X-ray where dye was inserted in the duct and initial viewing by what the surgeon called a junior radiographer said 'no restriction'. Surgeon not happy with this so wants to discuss with a senior radiographer which is where we are today.

Hope this isnt too long winded and thanks for all your interest
puter... interesting.

Gastric bypass for what? Do you mean gastric band for obesity?

Still am confused puter.

She had keyhole surgery and the Gall Bladder +stones were removed, but at the same time noted an "enlarged duct/ This could either have been the cystic duct (no big deal) or the common bile duct (big deal)


The big question is.......what is the nature of the narrowing (stricture)?

Keep me informed as to the result of the T-tube dye radiogram, as i am interested.
puter, is your wife having an E R C P ?
anne

" This has not caused any major problems for the surgeon other than if they cannot do an endoscopy down the throat because this now bypasses the 'plumbing' they would generally observe post op. I understand the bypass connects near to the pancreas further down the intestine. "

That is your answer.
thanks sqad, but that ^^^ is not the answer to my question to puter.
anne....sorry....I will let puter "spell it out " for you, perhaps in simpler terms.
From what I understand from what puternut said Anne, I don't think they can get the ERCP endoscope down in the right place to see what they need to because of the gastric bypass she had done.

Hope she's feeling much better soon puternut.
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Thanks for all the interest from you all - its appreciated. I will try and answer all here

anne

1] Yes she did have keyhole surgery but I think it unfair to say that these complications are because of that fact. I would rather it said that the problems that are arising since the initial op have come to light and could not have really been forseen before.

2] She cannot have an 'ERCP' - as pointed out by Jenna [Thanks for the regards Jenna]. I have converted a little diagram of my wifes internal - well all gastric bypass people really - organs here

http://s1107.photobuc...iew¤t=puter.jpg

and as you can see at the point in the blue circle the camera would need to effectively need to turn through too steep an angle.

Having said that the last x-ray she had was the 'CP' Part of ER'CP' in that she had a cholangiopancreatography performed to see what was happening as regards the restriction


Sqad:

No I do mean gastric bypass. She had 2 gastric bands inserted and both failed. One 'broke' or at least came apart in the ball socket and so was useless, second one port became blocked and so the band could not be adjusted and was too big.... so surgeon did a gastric bypass (A Roux-en-Y procedure I believe) for morbid obesity. Complete success with weight loss of about 14 stone (40% + of initial weight).

I do remember the term enlarged bile duct being mentioned but not cystic duct. Is this a concern? Also there is no drip of any sort in conjuction with bile drain?

LATEST NEWS
The results of the dye x-ray ('CP') have shown - as far as we have been told by junior registrar - a 'narrowing' of the intestine which will be put right by a balloon and/or a stent being inserted on the 24 August. She could come home until then but has chosen to stay in hospital as she is worried they will put her off if she is not on-hand immediately.

And as it is now past midnight I'm off to bed!!!!!!
puter thanks for the diagram and also your full and expert description.
My guess is that the constriction is at the the junction of the pancreas and duodenum and the bottom line seems to be....the cause and nature of the constriction.
This will take a bit of sorting out, so don't get depressed if her recovery is a little slow.

Again...excellent description and drawing.........keep is informed.
puter, thanks for excellent diagram, i hope all goes well for the future.
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Thanks guys - will report as and when

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