Removing a biliary T-tube and retained stones by ERCP. A case report.
A time-honored praxis is to insert a T-tube after open choledochotomy. Well-known complications of T-tube removal include bile leakage, peritonitis, sepsis and postoperative biliary stenosis. A retained T-tube fragment after surgical common bile duct exploration is an uncommon complication of T-tube removal. We report the first case of retained bile duct stones with a whole T-tube jammed into the biliary tree. A 31-year-old female with gallstone disease was operated on. The operation was started by laparoscopy but converted to open laparotomy because of perforation of the gallbladder. T-tube was inserted but several stones remained in the bile duct. Afterwards routine T-tube removal was impossible: the T-tube had become trapped in the common bile duct. This combination of complications was successfully treated by ERCP.
Heikkinen
Markku
M
Department of Internal Medicine, Unit of Gastroenterology, Kuopio University Hospital, Finland.
Poikolainen
Eero
E
Kaukanen
Erkki
E
Pääkkönen
Matti
M
D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D003135:Common Bile Duct / Q000000981:diagnostic imaging / Q000601:surgery*; D020878:Device Removal / Q000379:methods; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007813:Laparotomy / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation; D018570:Risk Assessment; D016896:Treatment Outcome