A drain that is used for drainage of bile after an open cholecystectomy is

GMCH - 2015

Medical & Surgical Nursing

Easy

Appeared in: GMCH - 2015

Explanation

A T-tube is specifically designed with a T-shaped crossbar that is placed directly into the common bile duct (CBD).
Its primary function is to drain bile externally after an open cholecystectomy, especially following exploration of the CBD.
This maintains the patency of the duct, prevents bile leakage into the peritoneum, and allows the duct to heal without pressure from bile accumulation.

Option A: A Penrose drain is a soft, flat, flexible tube that works by passive gravity drainage. It is an open system used for draining fluid from a superficial wound or abscess, not for controlled drainage from a specific duct like the CBD.
Option C: A Hemovac is a closed-suction (active) drain used to remove larger amounts of blood and serous fluid from a surgical site to prevent hematoma formation. It is not designed for placement within the biliary system.
Option D: A Jackson-Pratt (JP) drain is also a closed-suction (active) drain, but it uses a smaller, bulb-shaped reservoir. It is intended for draining smaller volumes of serosanguinous fluid from surgical sites.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types and Indications of Surgical Drains as background academic context rather than a clinical decision trigger.
Proper identification and management of surgical drains are fundamental nursing responsibilities to prevent postoperative complications like infection, fluid accumulation (seroma/hematoma), and skin breakdown.
For a T-tube, nurses must meticulously monitor the drainage characteristics (amount, color, consistency) as changes can signal complications like obstruction or hemorrhage.
What if? If T-tube drainage suddenly decreases or stops completely, it could indicate a blockage in the tube. The nurse's first action should be to check for kinks in the external tubing. If none are found, the patient should be assessed for pain, fever, or jaundice, and the surgeon must be notified immediately as this can lead to a dangerous buildup of bile.

How to Approach the Question

First, identify the key elements of the question: the type of fluid to be drained ('bile') and the specific surgical context ('open cholecystectomy').
Second, recall the different categories of surgical drains: passive vs. active (suction), and open vs. closed systems.
Third, consider the function of each option. Penrose is a passive, open drain. Hemovac and Jackson-Pratt are active, closed-suction drains.
Finally, match the specific need—draining bile from the common bile duct—with the drain designed for that unique anatomical purpose. The T-shape of the T-tube is the defining feature that makes it suitable for placement within a duct.

Concept Tested & Keywords

Q9bmg89nouG1D2iZvaHoEA

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 122-124