title: Prevention of Biliary Leakage after Removal of T-tube in Immunocompromised Patients.
abstract: Biliary leakage after T-tube removal is an important complication which can be lethal especially in patients who received immunosuppressant agents. The purpose of the study is to determine a method which can evaluate the completion of tract formation in high-risk patients. Participants include 46 patients who were candidates for open cholecystectomy and common bile duct (CBD) exploration and T-tube insertion. Twelve of patients received corticosteroids and were divided into two groups. In the first group, T-tube was removed conventionally, but in the other group, we performed a "fistulography" 1 month postoperative to evaluate maturity of tract between CBD and the skin. Biliary peritonitis was seen in half of patients who are managed conventionally, but no complication was detected in patients who underwent fistulography. Fistulography is suggested to be done before T-Tube removal in immunocompromised patients in order to detect tract formation, which is effective in reduction of postremoval complications.
authors.affiliation: Acute Care Surgery Research Center, Faculty of Medicine, Taleghani Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Soltani
authors.affiliation: Surgical Oncology Research Center, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Ibne Sina Street, Mashhad, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Mehrabi Bahar
authors.affiliation: Acute Care Surgery Research Center, Faculty of Medicine, Taleghani Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Paria
authors.initials: P
authors.lastname: Dehghanian
authors.affiliation: Surgical Oncology Research Center, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Ibne Sina Street, Mashhad, Iran.
authors.forename: Monavar
authors.initials: M
authors.lastname: Afzal Aghaei
authors.affiliation: Acute Care Surgery Research Center, Faculty of Medicine, Taleghani Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Samira
authors.initials: S
authors.lastname: Mozaffari
keywords: Biliary leakage; Fistulography; Immunocompromised patients; T-tube removal; Tract Formation