title: Development of T-tube tracts in piglets: effect of insertion method and material of T-tubes.
abstract: T-tube-related bile leakage is a considerable problem in liver transplantation but rather rare in surgery of biliary lithiasis. To investigate the effect of T-tube insertion method and material on the intraperitoneal T-tube tract, we performed a choledochotomy and insertion of T-tube (four of silicone, seven of latex, four of silicone with a latex sheath around the long arm) for 2 weeks on 15 piglets (choledochotomy group), and sutured a transected bile duct over a T-tube stent in nine piglets (five silicone, four latex), inserted similarly as in liver transplantations, for 6 weeks. Sixteen patients underwent cholectochotomy and T-tube drainage with a latex T-tube (n = 8) and latex-sheathed silicone T-tube (n = 8) for a median 9 (7-21) days. Histological examination of T-tube tracts in piglets was made, and complications after T-tube removal in the latex T-tube group were compared with those in the latex-sheathed silicone T-tube group. In piglets, latex T-tubes induced better tracts than silicone T-tubes (P < 0.05). Piglets in the choledochotomy group had tracts superior to those in the anastomotic stent group (P < 0.05). There was one bile leakage in the latex T-tube group, and none in the latex-sheathed silicone T-tube group. We conclude that T-tube tract development is affected by both the material and the insertion method of T-tubes. A silicone T-tube with a latex sheath around the long arm may also be a good choice for T-tube material in liver transplantation.
authors.affiliation: Helsinki University Central Hospital, Fourth Department of Surgery, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Koivusalo
authors.forename: M
authors.initials: M
authors.lastname: Eskelinen
authors.forename: H
authors.initials: H
authors.lastname: Wolff
authors.forename: M
authors.initials: M
authors.lastname: Talva
authors.forename: H
authors.initials: H
authors.lastname: Mäkisalo
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001646:Bile / Q000378:metabolism; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D007840:Latex; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D012828:Silicones; D015607:Stents / Q000009:adverse effects; D013552:Swine
chemical_list: D007840:Latex; D012828:Silicones