Retrospective Clinical Study of the Effects of T-Tube Placement for Bile Duct Stricture

Abstract

BackgroundT-tube placement in the common bile duct (CBD) is a surgical alternative to bile duct reconstruction in cholecystectomy for cholecysto-choledocholithiasis, or gallstones. The aim of this retrospective clinical study was to investigate the incidence of late complications of T-tube placement.Material/MethodsRetrospective review identified 35 patients who had T-tube placement during cholecystectomy. Clinical data were collected on surgical indications, patient demographics, and clinical symptoms. Ultrasound (US) was used measure the diameter of the common bile duct (CBD), intrahepatic ducts, and presence or absence of stones in the CBD. Data from laboratory investigations included the aspartate aminotransferase-to-platelet ratio index (APRI), which was used as a non-invasive method to evaluate both cholestasis and liver fibrosis.ResultsOf the 35 patients included in the study, 33 (94.3%) underwent open cholecystectomy, CBD exploration, and T-tube placement due to cholecysto-choledocholithiasis. The remaining two patients (5.7%) underwent primary CBD repair and T-tube placement secondary to CBD injury. The mean follow-up period after T-tube placement was 69 months. In patients with T-tube placement, the CBD diameters ranged from 4–21 mm, were normal in 20 patients (57.1%), dilated in 15 patients (42.9%), with the mean CBD diameter being 8.91±4.82 mm. No residual or recurrent CBD calculus and no clinical or laboratory evidence of cholangitis or cholestasis were found.ConclusionsA retrospective clinical study at a single surgical center, showed that T-tube placement during open cholecystectomy and CBD exploration was a safe procedure that did not result in late complications.

A Novel Remote-Controlled Injection Device for T-Tube Cholangiography: A Feasibility Study in Canines

“…T-tube cholangiography is the most commonly used method for the observation of the biliary tract after hepatobiliary surgery [ 3 – 7 , 12 ]. Despite the use of protective equipment such as lead aprons [ 13 ], clinicians in our hospital who perform T-tube cholangiography usually receive about 0.21 mSv of radiation per month.…”

“…The incidence of gallstone diseases in some developed countries ranges from 10% to 20% [ 1 , 2 ]. Many postoperative hepatobiliary diseases require biliary drainage [ 3 – 5 ], and T-tube is a kind of latex conduit used for biliary diversion in the common bile duct (CBD), and it is reported to reduce intra-biliary pressure and edema, prevent bile leakage, and may facilitate healing. Open surgery with CBD exploration and T-tube drainage are still traditionally performed in many selected patients with cholelithiasis and choledocholithiasis [ 6 ].…”

Pitfalls and promises of bile duct alternatives: A narrative review

“…If the length of the BDS implantation segment was less than 1 cm, tissues such as the omentum may migrate around it after inserting the T-tube into the defective bile duct segment[ 32 ]. Therefore, BDSs ≤ 1 cm and > 1 cm in length were considered separately.…”

Beni̇gn Ve Mali̇gn Di̇stal Koledok Darliklarinda Koledokoduodenostomi̇ Yapilan Hastalarin Retrospekti̇f Anali̇zi̇

“…Ancak, benign hastalıklar için KD'ye bağlı komplikasyonlara ek olarak, malign hastalıkta, tümör invazyonundan kaynaklanan anastomoz sahasında tekrarlayan biliyer obstrüksiyona yönelik endişeler KD'yi birtakım çekinceleri de olan palyatif bir seçenek haline getirmiştir (2,5). Son dönemlerde malign biliyer obstrüksiyon için endoskopik biliyer stent yerleştirme gibi cerrahi olmayan yaklaşımların kullanımının artması nedeniyle cerrahi tedavi uygulama oranları gittikçe azalmaya başlamıştır (6)…”