Chole with a t-tube?

[lpn1313]

Just a quick question. On the rehab unit I work, we have two patients with recent choles that both have t-tubes. Is this normal? I don't remember seeing this before, but it's been a while since I've worked with surgical patients.

[StacieRN, RN]

Yep. We had lots of t-tubes on chole pts. It depends on how much sludge is in the bile duct and how much bile is over produced. If there's a lot of sludge we had to irrigate up to every 4 hours. (depending on how thick drainage was, the doctor will order what is appropriate.

Just don't let it become stopped up. Makes radiology furious to have to replace. If suddenly drainage ceases, notify radiology at once.

Plus, chances for infection go up if not draining well. Watch temps. Pt will have a lot of pain so need to medicate first - but you need to palpate with assessment to be sure a pocket of infection not forming. Lots of times the infection is contained and WBCs will not rise, nor will temp. Only sign can be increased pain, palpation a hard area with discrete edges and decrease or cessation of drainage from t-tube. Will need a CT scan to verify infection.

[herecomestrouble]

I have a pt with a t-tube,the order is to flush twice a day,but it is kept clamped the rest of the time.I don't know why,it seems strange to me but that's what the doc wants.

[nursemary9, BSN, RN]

Hi

It seems to me that I used to see t-tubes REALLY often with open chole's in the "Good Old days!!

I sem to remember them almost all the time at one point

[fultzymom]

We have even had people who come to the LTC facility with them in place if they were really bad off. Then they go for a follow up and the doc will remove them when he feels it is time.