When should T-tube be removed after CBD exploration?
It is considered safe to remove latex T-tubes at 7–10 days. However, other authors prefer to leave latex T-tubes in for 21 days. Little evidence exists to suggest any benefit from a longer period of time.
Is the use of T-tube necessary after laparoscopic Choledochotomy?
Conclusion: Laparoscopic common bile duct exploration with primary closure without external drainage after laparoscopic choledochotomy is feasible, safe, and cost-effective. After verification of ductal clearance, the CBD could be closed primarily without T-tube insertion.
When do you remove at tube?
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.
How do you care for a T-tube?
Wet a cotton swab with normal saline solution (salt and water) or hydrogen peroxide and clean around the incision and tube site. But you can also clean the skin around the T-tube with soapy water. Pat dry with clean gauze. Put a new bandage on the incision and tube site.
What is the use of T tube?
T Tube is a draining tube placed in the common bile duct after Common Bile Duct (CBD) exploration with supra-duodenal choledochotomy. It provides external drainage of bile into a controlled route while the healing process of choledochotomy is maturing and the original pathology is resolving.
When is T tube removed?
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.
What is CBD in abdomen?
The common bile duct, sometimes abbreviated CBD, is a duct in the gastrointestinal tract of organisms that have a gallbladder. It is formed by the union of the common hepatic duct and the cystic duct (from the gallbladder). It is later joined by the pancreatic duct to form the ampulla of Vater.
How is CBD stone extracted from a T tube?
The T-tube is inserted in the common hepatic duct above the confluence of the cystic duct. B, The retained CBD stone is ensnared in the wire basket before extraction. This stone measured 5 mm in diameter and was extracted intact through the sinus tract of a 14-Fr T-tube. T-Tube Placement.
How to review T tube drainage of the common bile duct?
Review T-tube drainage of the common bile duct choleperitoneum: Etiology and management 1 Introduction. 2 History. 3 The role of materials. 4 Method of placement. 5 Post-operative management and surveillance. 6 T-tube removal. 7 T-tube complications. 8 Conclusions. 9 Disclosure of interest. …
Why is a T tube used in biliary surgery?
Historically, postoperative T-tube drainage has been used by biliary surgeons to prevent stasis, to decompress the biliary tree, to minimize the risk of leakage through a choledochotomy, and to prevent strictures with cicatrisation of a sutured choledochus.
What are the indications of a T tube?
Indications Indications of T Tube can be summarized in one concept that is to stent and drain the common bile duct after choledochotomy. The most common reason for performing choledochotomy is extraction of biliary stones. Choledochotomy, stone extraction and T Tube placement was common procedure for intractable stones before the ERCP era.
The T-tube is inserted in the common hepatic duct above the confluence of the cystic duct. B, The retained CBD stone is ensnared in the wire basket before extraction. This stone measured 5 mm in diameter and was extracted intact through the sinus tract of a 14-Fr T-tube. T-Tube Placement.
Why are T-shaped tubes used for bile drainage?
T-shaped tube drainage is the standard practice (9,10) to decompress the biliary tree and prevent bile leakage due to edema and spasm of the sphincter of Oddi, (11,12) It has the advantages of easy post operative X-ray visualization of CBD, and the potential for T-tube tract extraction of missed stones.
What is the purpose of a T tube?
Role of the t-tube? It will serve as a drain that will drain off excessive bile and will be removed once healing has taken place. It can also be used for testing where dye is injected into the t-tube and x-ray imaging is taken (cholangiogram) to assess the biliary tree and duct like the picture below.
Which is better primary closure or T tube drainage?
There is a lower biliary complication rate associated with primary closure of the CBD than after T-tube drainage. It allows a post operative cholangiography and forms a route for the management of residual stones.