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Bile Drainage

Test indications: For the detection of malignant cells arising within the hepatobiliary system.

Specimen required: 10 mL or more of collected bile drainage.

Supplies: Standard transcutaneous or endoscopic biliary drainage equipment. Clean plastic specimen container of an appropriate size, biohazard transport bag, patient requisition.

Collection procedure: Using appropriate sterile technique, collect as much bile drainage through the drainage apparatus as possible into a clean plastic specimen container. Label the container with patient’s first and last name, date of birth, and specimen source. Place specimen in biohazard transport bag. Submit the specimen and the completed test request form to the Cytopathology Laboratory.

Fixation: Preferred specimen: Fresh, no fixative. If transport will be delayed for more than one (1) hour, add an equal amount of 50% ethanol to the specimen. The specimen should be refrigerated or kept on wet ice until transport to the lab if transport time will be less than one (1) hour or fixative is not available.

Transport: Each specimen should be placed in a clearly labeled container that is leak proof. Place specimen inside a biohazard transport bag. Paper requisition(s) that accompany the specimen or slides in fixative should be placed in the outside pocket of the biohazard bag to avoid exposure to any leakage of fixative.

Causes for rejection: Incomplete patient requisitions, unlabeled/incorrectly labeled specimen, frozen specimen, incorrect test ordered for specimen, specimen in incorrect or expired fixative, specimen from unauthorized person.

Specimen stability: 1 hour, fresh sample. Bile specimens will degenerate very rapidly due to enzymatic activity and bile salts. Therefore, a 24-hour bile collection is not suitable for cytopathologic evaluation.

Report interval: By report.

CPT code(s): 88108 Concentration and interpretation, 88112 Selective cellular enhancement with interpretation. Additional CPT codes may apply if special studies are required.

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