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

Ahmed, M; Diggory, R

doi:10.1308/003588413x13629960048596

Cited by 14 publications

(13 citation statements)

References 19 publications

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“…Long-term retention of T-tube is associated with risk of track infection and bile leakage besides being an uncomfortable accessory for the patient. [3–5] Primary closure is associated with risk of stenosis and recurrent cholangitis. [6] For this reason, a biliary stent that is amenable to spontaneous removal in a reasonable time, without the need for any further intervention, is an attractive option, which may avoid the aforementioned complications.…”

Section: Introductionmentioning

confidence: 99%

Spontaneously removed biliary stent drainage versus T-tube drainage after laparoscopic common bile duct exploration

Dong²,

Ma³

et al. 2016

Medicine

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Several studies have shown the safety and feasibility of laparoscopic common bile duct exploration (LCBDE) as a minimally invasive treatment options for choledocholithiasis. Use of T-tube or biliary stent drainage tube placement after laparoscopic choledochotomy for common bile duct (CBD) stones is still under debate. This study tried to confirm the safety of spontaneously removable biliary stent in the distal CBD after LCBDE to allow choledochus primary closure. A total of 47 patients with choledocholithiasis underwent LCBDE with primary closure and internal drainage using a spontaneously removable biliary stent drainage tube (stent group, N = 22) or T-tube (T-tube group, N = 25). Operative parameters and outcomes are compared. Surgical time, intraoperative blood loss, length of hospital stay, drainage tube removal time, postoperative intestinal function recovery, and cost of treatment were all significantly lower in the stent group as compared to that in the T-tube group (P < 0.05 for all). Otherwise, Bile leakage between the two groups had no significant difference (P > 0.05). The biliary stent drainage tube was excreted spontaneously 4 to 14 days after surgery with the exception of one case, where endoscopic removal of biliary tube was required due to failure of its spontaneous discharge. LCBDE with primary closure and use of spontaneously removable biliary stent drainage showed advantage over the use of traditional T-tube drainage in patients with choledocholithiasis.

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Section: Introductionmentioning

confidence: 99%

Spontaneously removed biliary stent drainage versus T-tube drainage after laparoscopic common bile duct exploration

Dong²,

Ma³

et al. 2016

Medicine

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“…However, this practice is associated with significant T-tube-related complications that include drain site pain, biliary leak, CBD obstruction due to accidental tube dislodgement, persistent biliary fistula, and biliary peritonitis due to tube dislodgement or after T-tube removal. These complications are reported to occur in approximately 15 % of patients with TTD [13,14]. Furthermore, T-tube insertion after laparoscopic or open CBDE is associated with prolonged hospital stay, longer operating time, and higher hospital expenses [6,[15][16][17][18][19].…”

mentioning

confidence: 99%

Systematic review with meta-analysis of studies comparing primary duct closure and T-tube drainage after laparoscopic common bile duct exploration for choledocholithiasis

et al. 2015

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“…[19] On the other hand, Ttube drainage is also a popular reconstruction technique considering the advantages it provides for the drainage of a partially cleaned or edematous bile duct, in removing retained stones from the tract and performing postoperative cholangiography. [20] However, the T-tube may cause an inflammatory reaction along the drainage tract, creating a biliocutaneous fistula. The risk of developing biliary peritonitis following the removal of the T-tube has been reported to be between 2.5%-19.6% with a 4.3% reoperation and a high mortality rate.…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Laparoscopic And Conventional Technique In The Surgical Treatment Of Choledocholithiasis

Aydın¹

2020

Laparosc Endosc Surg Sci

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Introduction:The aim of the study is to compare f conventional and laparoscopic techniques in common bile duct exploration in terms of efficacy and safety. Materials and Methods:The data of 280 patients who underwent surgical procedure for common bile duct stones between January 2011 and December 2016 were retrospectively analyzed. This was an Ethics Committee-approved retrospective analysis of data between 2011 and 2016. The patients were divided into two groups according to the common bile duct exploration technique: laparoscopic (Group 1, 164 patients) and conventional (Group 2, 116 patients). The two groups were compared in terms of surgical findings and short-term results.Results: 170 (60.7%) of the patients were women. The mean age was 61.9±16.9 years. Clinical results showed that the operative time (120±35.9 vs 169±48.4 minutes, p<0.01) and hospital stay (6.3±3.9 vs 10.9±6.8 days, p<0.01) were shorter in Group 1; overall morbidity (9% vs 24%, p<0.01) and mortality rates (1.2% vs 6%, p<0.03) were lower. Postoperative endoscopic sphincterotomy requirement was less (7% vs 18.1%, p <0.01). In addition, in Group 1, there was a higher rate of stone clearance (93.9% vs 82.8%, p<0.01) with a lower rate of wound infection (0.6% vs 10.3%, p<0.01). No difference was observed in terms of re-operation, bile leakage or drain dislocation. Conclusion:In terms of stone clearance, hospital stay, morbidity, mortality and complication rates, laparoscopic common bile duct exploration is a significantly safer and more effective method compared to conventional exploration.

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

Cited by 14 publications

References 19 publications

Spontaneously removed biliary stent drainage versus T-tube drainage after laparoscopic common bile duct exploration

Spontaneously removed biliary stent drainage versus T-tube drainage after laparoscopic common bile duct exploration

Systematic review with meta-analysis of studies comparing primary duct closure and T-tube drainage after laparoscopic common bile duct exploration for choledocholithiasis

Comparison Between Laparoscopic And Conventional Technique In The Surgical Treatment Of Choledocholithiasis

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