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t tube care
Nursing Care of the T-Tube after Cholecystectomy

Also called a biliary draining tube.
May be placed in the common bile duct after cholecystectomy or choledochostomy.
The tube facilitates biliary drainage during healing.
The surgeon inserts the short end (crossbar) into the common bile duct and draws the long end through an incision in the skin. The tube is then connected to a closed gravity drainage system.
Post-operatively it remains in place between 7 to 14 days.
Equipment
Graduated collection container
Small plastic bag
Sterile gloves and clean gloves
Clamp
Sterile 4”x4” gauze pads
Transparent dressings
Rubber band
Normal saline solution
Sterile cleaning solution
Two sterile basins
Providone-iodine pads
Sterile precut drain dressings
Hyperallergenic paper tape
Skin protectant
Montgomery strips
Preparation of equipment
1. Assemble the equipment at the bedside
2. Open all sterile equipment. Place one sterile 4”x4” gauze pad in each sterile basin
3. Using sterile technique, pour 50ml of cleaning solution into one basin and 50 ml of normal saline solution into the other basin.
4. Tape a small plastic bag on the table to use for refuse
Procedure
1. Verify the patient’s identity using two patient identifiers, such as the patient’s name and identification number.
2. Provide privacy and reinforce the explanation of the procedure to the patient
3. Wash hands
Emptying drainage
1. Put on glean gloves
2. Place the graduated collection container under the outlet valve of the drainage bag. Without contaminating the clamp, valve, or outlet valve, empty the bag’s contents completely into the container and reseal the outlet valve.
3. Carefully measure and record the character, color, and amount of drainage.
4. Discard gloves
Clamping the T-tube
1. As ordered, occlude the tube lightly with a clamp or wrap a rubber band around the end. Clamping the tube 1 hour before and after meals diverts the bile back to the duodenum to aid digestion.

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