title: Common bile duct T-tubes. A caveat and recommendations for management.
abstract: Operations on the common bile duct can result in severe long-term consequences. To prevent some of these complications, it is common practice to drain the biliary tree with a T-tube. The T-tube is usually removed 2 weeks after it was placed. There have been numerous reports of bile leak following T-tube removal in the literature. These leaks can result in bile ascites, biloma, or bile peritonitis. Control of bile leaks can be accomplished in a number of ways, including endoscopically or radiologically placed stents or drains and radiologic techniques to drain the fluid collections. We describe a novel technique that can be utilized at the time of T-tube removal that will allow immediate control of the bile leak and prevent the complications of bile accumulation within the peritoneal cavity. We have performed fluoroscopic removal of T-tubes on two patients and found no complications with the technique. We have successfully visualized the T-tube tract in both patients. The T-tube tract can be visualized at the time of T-tube removal in an effort to prevent the complications of tract disruption and subsequent bile leak.
authors.affiliation: George Washington University, Washington, DC 20037, USA.
authors.forename: L K
authors.initials: LK
authors.lastname: Jacobs
authors.forename: V
authors.initials: V
authors.lastname: Shayani
authors.forename: J M
authors.initials: JM
authors.lastname: Sackier
mesh_terms: D001201:Ascites / Q000209:etiology; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D002758:Cholangiography; D002763:Cholecystectomy / Q000009:adverse effects*; D003135:Common Bile Duct / Q000601:surgery*; D019468:Disease Management; D005471:Fluoroscopy; D006801:Humans; D010538:Peritonitis / Q000209:etiology