About cholecystectomy After bile duct exploration, bile drainage

The daily bile drainage volume of 1900ml is a bit more, and the bile drained by the T tube after biliary exploration in my patients is generally about 300ml. In this case, it is necessary to observe the character, color, and presence of suspended solids in the bile. There are several reasons to consider:

1.First of all, it is necessary to consider that the lower end of the bile duct is not patency, which can be confirmed by a T-tube contrast examination about 10 days after surgery; 2.The lower end of the bile duct is too obstructed and the intestinal fluid refluxes into the bile duct, in which case the color of the bile drained from the T duct is abnormal, and some intestinal contents will float, in this case, T ductography or upper gastrointestinal barium swallow examination is also required; 3.

If you have chronic liver disease or liver damage before surgery, you may have more bile during the recovery period, but the bile may be lighter in color; 4.The large production of bile itself, combined with the thicker T duct, causes most of the bile to drain out of the body.

In this case, fluid and electrolyte replacement should be taken care of along with the necessary tests to avoid dehydration and electrolyte imbalances.

Do a cholangiogram to see if the common bile duct is open and if there are residual stones, if not, but there is nothing abnormal about the higher quality.

There must be a problem, the bile secretion is about 800-1200 per day, whether there is intestinal reflux, look at the color, check the liver function, whether there is hypersecretion of the liver. Take care to maintain a balance of water and electrolytes.

Answer]: Too little C may be caused by "T" duct obstruction or liver failure, and too much may be due to the lower end of the common bile duct.

Answer]: B biliary fistula is a serious complication after choledochotomy and stone removal, should be closely observed, if the patient postoperative abdominal drainage is volatile, the drainage tube will flow out of the "bile" like fluid, and the possibility of biliary fistula should be considered in combination with other manifestations such as fever and lack of state, abdominal distension or abdominal pain.

Roll to know the answer]: c

Biliary fistula is a serious complication after choledochotomy and stone removal, and should be closely observed, and the possibility of biliary fistula should be considered if the patient has a large postoperative drainage tube drain to compensate for the discharge of bile-like fluid, combined with other manifestations such as fever, abdominal distension, or abdominal pain.

Recommendation: gallbladder resection + choledocholithotomy + T-tube drainage.

Your problem is complex, and you don't specify when and how you will operate. Here I can only illustrate some common situations.

First of all, it should be clear that "bile duct blockage" is definitely not possible, the common bile duct is the only channel for bile excretion, if blocked, bile reflux into the blood will form jaundice (**, yellowing of the eyeball), because bilirubin is toxic, if the concentration is too high, it will damage the central nervous system, and in serious cases, it will be fatal. The good thing is that you still have a drainage tube that can drain bile out of your body, so it won't have any effect in the near future, so you don't have to worry too much, but the common bile duct will not work for a day, and your drainage tube will not be able to be removed for a day.

Now let's focus on the reasons for the obstruction of the bile ducts: 1. Stones - you have undergone surgery, if there are any, it is likely to be related to the failure of the surgery to remove the stones - it is impossible to form a stone as large as blocking the common bile duct in just a few months: you should communicate with the hospital about this.

2. Local inflammatory edema, which is also relatively common, after the inflammation subsides, the bile duct will be restored, hopefully;

AbstractAnti-infective**: Antibiotics can be used to prevent bacteremia and purulent complications, such as a combination of aminbenzylpenicillin, clincomycin, and aminoglycosides, or cefurazole or cefuroxime**. Antibiotic change should be based on clinical blood cultures, bile cultures, bacterial cultures of the gallbladder wall, and drug susceptibility testing.

Choleretic drugs: oral 50% magnesium sulfate, note that it is not available for those with diarrhea, oral deoxycholic acid tablets, etc.

What is going on with the bile flowing through the gallbladder intervention drainage tube gradually becoming less and then more Hello, I have seen your question and am sorting out the answer, please wait a while Hello! Generally, when the inflammation is severe, it will become more.

Well, what to do then.

There is only anti-inflammatory, there is no other good way.

It's been 23 days since surgery.

What kind of medicine is taken orally?

Must be taken orally with a hanging bottle.

Can anti-inflammatory drugs always be used?

If the inflammation does not go down, it must be anti-inflammatory, and it is not a question of whether it can be used to fight infection**: in order to prevent bacteremia and purulent complications, antibiotics can be used, such as aminbenzylpenicillin, clincomycin, and aminoglycosides, or cefurazole or cefuroxime**. Antibiotic change should be based on clinical blood cultures, bile cultures, bacterial cultures of the gallbladder wall, and drug susceptibility testing.

Choleretic drugs: oral 50% magnesium sulfate, note that it is not available for those with diarrhea, oral deoxycholic acid tablets, etc.

This is just a suggestion, everyone is different, the medicine used is different, or according to the condition of the doctor's advice is better.

Okay thank you! You are welcome.

Did your father have cholecystectomy + choledochotomy and drainage + T-tube drainage a month and a half ago or emergency cholecystectomy + cholangostomy drainage for abdominal pain?

The above two types of surgery can generally remove the drainage tube about 2 weeks after the operation, and your father is discharged from the hospital with the tube, indicating that the biliary tract still has stones or is not very clear. Doctors need to observe before proceeding further**. This kind of surgery must strengthen nutrition, otherwise it is easy to have complications of bile leakage due to malnutrition affecting wound healing, and the doctor will be able to perform the operation in time**, otherwise your father's life will be in danger.

This condition is not considered medical malpractice. I understand your feelings. Please cooperate with the doctor, actively control the infection, strengthen nutritional intake, and promote the improvement of your father's own immunity.

May your father be healed soon!

Hello. Because your information is not comprehensive, 1 Was the gallbladder stone perforated at that time?

2 Is the drain in the gallbladder fossa?

3 Is there fluid coming out of the drain after surgery? What color?

4 Will there be fluid outflow on the same day after the drain is removed? What color? Is it the same color as the drain?

5 Do you have a fever after removing the drain? Is the blood item high?

In short, it is recommended that you go to your doctor in charge again to ask and do abdominal ultrasound, there should not be too much of a problem.

1 If you are coming out with yellowish bile, it will not be easy to deal with, and it may be a bit of a bile leakage.

2 If there is a thin turbid fluid coming out, there may be a local infection.