4 weeks later still draining

[I_had_gangrene]

I  had open gall bladder surgery 4 weeks ago. I went home with a JP drain. At first I was getting 60-70 ml per day, then it shot up to 130-140 ml so I went to emergency room. The doctor on duty wouldn't order any tests without my surgeon's say-so, so he got my surgeon on the phone and she said "no tests". So they sent me home. It subsided again, at four weeks the drainage is around 80-90 ml. I think it's too much. I think there is a problem, a stone in the duct or something. My surgeon keeps telling me everything is OK, it just takes time. How much time? At what point should my surgeon send me for some kind of test to see if something is wrong in there? Should I see another doctor, or will another doctor just do whatever the first doctor says, the way the emergency room doctor did?

[lilkarla]

I too had my GB removed in April - no stones.  Mine was laproscopic though but I returned 7 days later to ER after being in pain for days.  I had a rare second bile duct (luschka) and it was leaking after the removal.  I had a stent placed and it stopped immediately.  Before the ERCP they did a HIDA scan and found the leak but did not know what was leaking.  The obvious was the central bile duct but my surgeon was "Confident that it was not nicked in surgery".  He told me he has never in 20 years nicked and nicks are rare.  Your doctor should be more understanding of the pain from a bile leak.  Also, the leak needs to be stopped.  I was in the hospital for 13 days until they were sure all the bile was absorbed by my body.  They would not consider sending me home.  I was on fluids, antibiotics and pain medicine and had CAT scans every couple of days to trace the bile.  Sounds like you need more help than what your doctor is giving.  Tell her you are going to get a second opinion and see if she steps up her game.  Please keep me posted.  I know how painful bile leaks are.  Your entire body is on fire.  Only morphine dulled the pain.

[I_had_gangrene]

Thanks for your reply. Yes, it is bile. The higher the total volume is, the more green it is.

She told me I had two huge stones and numerous smaller ones, and that it was gangrenous (hence the nick). She said she left a remnant of the gall bladder there because it was so swollen it was hard to tell where the ducts were. That's why I'm thinking there's still a stone in there, in the "remnant" where she couldn't see it.

It's going to be awkward asking the doctor for her notes. Have to work my courage up for this! I will definitely ask for a test- I think it was a CAT scan I had before.

[CalGal]

Since this a 4 weeks post-op, I'd suggest you push the issue a bit either with you present doc or ask for a second opinion. And if the fluid you are draining is bile, you definitely need to know why the leakage is happening. Get a written copy of your docs notes and the records from the operation and read them. They will give you the general content of what was found and done during the operation and why the drain was placed.