Percutaneous Drain with or without Tube Placement

Pre-Procedure Patient Information

What is Percutaneous Drain?

A percutaneous drain can be placed for multiple reasons to drain fluid or infection from various parts of your body. This is done by placing a thin needle under the skin and moving it into the area that needs to be drained. A small tube (catheter) is then inserted and is left in place to continue to drain the fluid into a collection bag outside your body. Your ordering provider will let you know when it can be removed. It is also possible that the fluid will be removed by a syringe and no tube will be left in place. Some examples of drains that we place are as follows:

  • Percutaneous abcess drain placement is a procedure to place a drain to remove a collection of infected fluid from inside the body (abscess).
  • A biliary drainage catheter is placed to keep bile from backing up into the liver. Bile is a thick yellow or green fluid that helps digest fat in foods. Backup of bile can occur when there is a blockage that prevents bile from moving from the bile ducts into the small intestine as it should. The blockage can be caused by gallstones, a tumor, or scar tissue.
  • Cholecystostomy is a procedure to drain fluid from the gallbladder by using a catheter. The gallbladder is a pear-shaped organ that lies beneath the liver on the right side of the body. The gallbladder stores bile, which is a thick yellow or green fluid that helps digest fat in foods. You may have this procedure:
    • If your gallbladder is swollen or irritated due to bile build up
    • To prepare you for gallbladder surgery
    • To control your symptoms if you cannot have gallbladder surgery
  • Percutaneous nephrostomy is a procedure to insert a flexible tube into your kidney so that urine can leave your body. This procedure may be done if a medical condition prevents urine from leaving your kidney in the usual way. Urine is normally carried from the kidneys to the bladder through narrow tubes called ureters. A ureter can become blocked because of conditions such as kidney stones, tumors, infection, or blood clots. Draining the urine will relieve pressure and help prevent infection that could damage the kidney. Often, this procedure allows your health care provider to identify the cause of the blockage and plan appropriate treatment.
  • An indwelling pleural catheter drains excess fluid that collects in the area between the chest wall and the lungs (pleural space). The pleural catheter will allow you to drain fluid from your chest at home on a regular basis (sometimes daily). This will eliminate the need for frequent visits to the hospital or clinic to drain the fluid.
  • An indwelling acites catheter drains excess fluid that collects in your abdomen. The acites catheter will allow you to drain fluid from your abdomen at home on a regular basis (sometimes daily). This will eliminate the need for frequent visits to the hospital or clinic to drain the fluid.

What conditions should I make sure my doctor is aware of?

Before your exam, you should notify the doctor or nurse of:

  • Any drug/food allergies
  • Any blood thinning medications (anticoagulants) that you are taking
  • Any medical conditions you have
  • If you have an active infection
  • Whether you are pregnant or may be pregnant
  • Any problems you or your family members have had with anesthetic medications

What are the risks?

Generally, this is a safe procedure. However, as with any procedure, complications can occur. Possible complications include:

  • Infection
  • Bleeding
  • Allergic reactions to medicines or dyes used in the procedure
  • Damage to other structures or organs

About the Procedure

Before the procedure:

  • Your health care provider may want you to have blood tests. These tests can help tell how well your kidneys and liver are working. They can also show how well your blood clots.
  • Do not eat or drink within eight hours of your appointment.
  • If you have diabetes and use insulin, you may need to adjust the dosage of insulin the day of the procedure. Your primary care doctor can help you with this adjustment.
  • If you are on blood thinning medications, you may need to stop them prior to the procedure. Check with your primary care doctor about when it is safe to stop blood-thinning medicine.
  • Do not discontinue any medication without first consulting with your primary care or referring physician.
  • Do not take new dietary supplements or medicines during the week before your procedure unless your health care provider approves them.
  • Plan to have someone take you home and stay with you for the first 24 hours after you leave the hospital. You should not drive or operate heavy machinery for at least 24 hours after the procedure. 

The day of the procedure:

  • Make sure you shower on the day of your procedure, washing the anticipated procedure site with soap and water.
  • If you were told to take a medication or to continue taking a medication on the day of the procedure, take the medication with a small sip of water.
  • Please arrive and register at admissions in the lobby of the hospital at your scheduled time.
  • You will be escorted to the prep area, where you will be connected to a blood pressure machine that will take your blood pressure and your heart rate. You will also have electrocardiogram (ECG) leads placed on your chest to allow us to monitor your heart during the procedure.
  • A nurse will insert an IV into your arm. During the test, this IV may be used to give you medications. These medications may include medicine to help you relax and help reduce pain. The nurse will also review your medical history and medications, listen to your heart and lungs and make sure you have followed all your pre-procedure instructions.
  • The Radiologist will obtain your consent for the procedure. The Radiologist will explain the procedure including possible complications and side effects. They will also answer any questions you may have.

During the procedure:

You will be awake during the procedure. You may be given medication through your IV to help you relax and reduce pain. Your will be positioned to allow the best possible access to the drain site. Let the staff know if the position is not comfortable. The site of the drain insertion will be cleansed with a special antiseptic solution. Sterile drapes will be placed. The doctor will inject a small amount of local anesthetic through a very small needle in the skin where the drain will be inserted. It feels like a pinch and then a slight burning as the local anesthetic starts numbing the skin.

A needle is inserted through your skin. Imaging is used to guide the needle to the area to be drained. If a tube is to be placed, a wire may be used to place the drainage catheter, which is thin and flexible. The tube may be secured to your skin with stitches (sutures) and/or a securement device. Your skin will be cleansed and a bandage will be applied. A drainage bag will be attached to the tube to allow the fluid to drain.

After the procedure:

  • You will stay in the recovery area for observation for 30 minutes – 2 hours.
  • You will be asked about your pain.
  • You will be taught how to care for the tube and the drainage bag.
  • The nurses will review your discharge instructions with you.
  • You will then be discharged home. Someone must drive you home and stay with you for 24 hour.

Can I resume normal activities?

  • Do not drive or operate heavy machinery for 24 hours after the procedure.
  • Resume your normal diet.
  • There may be other restrictions depending on your specific drain.

What do I do for follow up visits?

Please make a follow up appointment with your ordering physician for follow up care. Your ordering physician will help you order dressing supplies and discuss next steps.

Contact Information:

Contact your ordering physician for any questions or concerns to include:

  • Procedure site problems to include:
    • Redness, swelling, or pain
    • Fluid or small amount of blood
    • Pus or a bad smell
  • You have fluid leaking from around your catheter (instead of through your catheter).
  • You have a fever that does not get better with medicine.
  • You suddenly stop having drainage from your catheter.
  • You feel like you may vomit (nauseous) or you vomit.
  • Your skin becomes itchy or you develop a rash or hives.

Get help right away if:

  • Your catheter comes out.
  • You suddenly have blood in the fluid that is draining from your catheter
  • You have very bad bleeding from tube insertion site.
  • You have chest pain.
  • You are short of breath or have trouble breathing.
  • You feel dizzy or you faint.

These symptoms may be an emergency. Get help right away. Call 911.

  • Do not wait to see if the symptoms will go away.
  • Do not drive yourself to the hospital.