Bile leak after T-tube removal--a scintigraphic study.
OBJECTIVE
A prospective study was performed to evaluate the incidence of bile leak after T-tube removal, using 99mTc labelled BULIDA scintigraphy.


METHODS
Thirty seven patients with choledocholithiasis underwent choledocholithotomy and T-tube drainage. T-tubes were removed on 9--26 postoperative day (mean 13.4 days).


RESULTS
Six (16%) patients had scintigraphic evidence of bile leak; 4 patients had leak demonstrated in the early phase only. One patient each had partial persistent leak and complete bile leak. All patients were managed nonsurgically; conservative treatment: (4), percutaneous drainage (PCD) of intra-abdominal collection (1) and endoscopic sphincterotomy and PCD of intra-abdominal collection (1). There was no significant difference in the leak rate when T-tubes were removed at < 2 weeks versus later than 2 weeks (P=.97).


CONCLUSIONS
T-tubes should be removed with extreme caution and treatment of symptomatic patients should be guided by clinical and scintigraphic findings.
Kacker
L K
LK
Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Mittal
B R
BR
Sikora
S S
SS
Ali
W
W
Kapoor
V K
VK
Saxena
R
R
Das
B K
BK
Kaushik
S P
SP
D001646:Bile; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D015994:Incidence; D007440:Intubation; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011143:Polyvinyl Chloride; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013997:Time Factors
D015609:Organotechnetium Compounds; D011143:Polyvinyl Chloride