Biliary peritonitis requiring reoperation after removal of T-tubes from the common bile duct

Closure of the Common Duct -Endonasobiliary Drainage Tubes vs. T Tube: A Comparative Study

“…A similar result (50% radiological leak) and 7% biliary peritonitis was obtained by Mosley et al in his study [38]. Literature is full of reports of bile leaks occurring at the time of T tube removal [27,30,33,37,39,40] In the ENBD group there is no opening in the CBD and no chance of trauma to the wall at the time of its removal, therefore there is almost no reason for a bile leak. Even if the ENBD gets displaced early as happened in three of our patients, or is removed early as was the case in one of the patients no leak occurs.…”

Case-based review: bile peritonitis after T-tube removal

“…13 Conversely, Maghsoudi et al recorded the lowest incidence of bile peritonitis of 2.5% a large cohort of 1,345 patients but recorded all of these patients being returned to theatre. 8 The mortality as a result of bile peritonitis is low, ranging from 0% to 1.8%. 8,[10][11][12][13] When we look at the timing of T-tube removal in relation to cases of bile peritonitis, a clear trend is observed.…”

“…8 The mortality as a result of bile peritonitis is low, ranging from 0% to 1.8%. 8,[10][11][12][13] When we look at the timing of T-tube removal in relation to cases of bile peritonitis, a clear trend is observed. Studies by Domellöf et al 13 and Gillatt et al, 12 in which the median length of time before T-tube removal was only 7 days, have incidences of bile peritonitis of 19.6% and 19.4% respectively.…”

“…8 The majority of these cases will settle with conservative measures but up to 4.3% of these patients will need to return to theatre. 10 This study suggests that bile peritonitis is not as 'exceedingly rare' as it is considered traditionally but rather a common complication of T-tube removal.…”

“…Studies have shown no benefit in terms of fibrosis from leaving a latex T-tube in place for 6-12 weeks. 8,9 The incidence of bile peritonitis after removal of latex T-tubes ranges from 2.5% to 19.6%. 8,[10][11][12][13] The incidence of patients returning to theatre as a consequence of bile peritonitis lies between 0% and 4.3%.…”