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T-Tube Cholangiogram

Patient Care

Sydney Bruce

on 23 May 2013

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Transcript of T-Tube Cholangiogram

T-Tube Cholangiogram A t-tube cholangiogram is a special x-ray procedure that is done with contrast media to visualize the bile ducts after the removal of the gallbladder. This procedure will visualize any stones remaining in the bile ducts. T-Tube Cholangiogram T-Tube Cholangiogram T-Tube Cholangiogram T-Tube Cholangiogram Contrast T-Tube Cholangiogram Recovery Time T-Tube Cholangiogram T-Tube Cholangiogram Indications Contraindications Preparations NPO 4 hours prior
Signed consent
Tube is clamped the day before to fill with bile, preventing air bubles
Standard preoperative preparation is, however, required before the cholecystectomy
Food and drink restrictions Allergy to iodine
Shellfish allergy
Previous reaction to contrast
Barium study within last 3 days
Patient refusal Patient's with possibility of residual small gallstones post cholecystectomy
Bile duct strictures
Obstructive jaundice
Abnormal growths
Abnormal fistulae Iodine based
Water soluble
20 cc inserted If the T-tube is left in place, a sterile, closed drainage system is attached to it.
If the tube is removed, a nurse applies a sterile dressing and records any drainage. The dressing is changed as necessary.
You may gradually resume your normal activities.
Patient can eat and drink normally T-Tube Cholangiogram Sydney Bruce Equipment Needed Projections Patient begins supine
After contrast is inserted, the patient moves through a variety of different positions to help better visualize the ducts.
After about 15 minutes has passed since contrast injection, a final erect image is taken to record the emptying of contrast-laden bile into the duodenum X-ray table
Flouroscopy tube
T-tube inserted into the bile duct
20 cc syringe
18 gauge needle
2 providone-iodine swabs
21 gauge butterfly needle & tubing
Sterile 4X4 gauze
20 cc 30-40% iodine water-soluble intravascular contrast Extras If trouble arises while trying to fill the ducts, placing the patient in the trendelenburg position will normally help.
It is important to check for bile leakage at the wound site.
Also, be aware of any itching or rash after the procedure The Radiographer's Role A T-shaped tube is inserted into the bile duct during the cholecystectomy and is left in place. After about a week, contrast is inserted into the tube and x-rays are taken. If there are no stones, the tube is pulled out. If there are stones, they may be removed via ERCP or by a stone-dissolving solvent administered through the tube. T-Tube Cholangiogram The Procedure After gallbladder removal surgery, a T-tube is left in place to facilitate drainage.
Cholangiography typically occurs 5 to 10 days later.
You will lie on your back on an x-ray table. An antiseptic solution is used to cleanse the T-tube.
The contrast dye is injected into the T-tube. You may feel a bloating sensation in the upper right abdomen as it is injected.
X-rays and fluoroscopy are used to visualize the biliary tract. You are instructed to assume various positions as x-ray films are obtained.
The procedure takes about 15 minutes T-Tube Diagram of a T-Tube inserted into the common bile duct This examination uses x-rays and a contrast agent to produce an image of the biliary drainage system. Contrast is injected through an existing T-tube (catheter) and radiographic images are obtained.
The radiographer assists in the injection of contrast, answering any patients' questions or concerns, and obtaining the radiographic images for the study.
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