Bile duct injuries related to misplacement of “T tubes”
Introduction: T tubes can be placed in the bile ducts either open or laparoscopically for several reasons such as: extraction of stones, biliary reconstruction after liver transplant and in end-to-end anastomosis in iatrogenic injuries. Inadequate placement of the T tube, long term stay and technica...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2006-01-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119320393 |
| _version_ | 1818839090915704832 |
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| author | Miguel Ángel Mercado Héctor Orozco Alexandra Barajas Olivas José Manuel Villalta Ismael Domínguez Javier Eraña Fernando Poucel Carlos Chan |
| author_facet | Miguel Ángel Mercado Héctor Orozco Alexandra Barajas Olivas José Manuel Villalta Ismael Domínguez Javier Eraña Fernando Poucel Carlos Chan |
| author_sort | Miguel Ángel Mercado |
| collection | DOAJ |
| description | Introduction: T tubes can be placed in the bile ducts either open or laparoscopically for several reasons such as: extraction of stones, biliary reconstruction after liver transplant and in end-to-end anastomosis in iatrogenic injuries. Inadequate placement of the T tube, long term stay and technical difficulties that can affect the outcome, can lead to an injury that usually requires a biliodigestive reconstruction.Methods: In a 15-year period (1990–2005) a total of 343 patients have been referred to our university hospital for biliary reconstruction. Files of those patients in which the injury was due to misplacement of a T tube or associated with a long-term stay were reviewed. We evaluated the type of injury, technique used for the reconstruction, longterm staying of the T tubes (1–6 months), hospital in stay, long term outcomes as well as associated comorbidities.Results: In 42 cases a biliary injury related to a T tube was identified (13%). All the injuries were classified as Strasberg E, with demonstration of a fistula (internal or external); 18 to the duodenum, 5 to the jejunum – ileum and 3 to the colon. A hepatojejunostomy was done to all patients; the duodenum and small gut fistulas were closed and in the 3 cases with colonic injury a right hemicolectomy was performed. The postoperative evolution was adequate without major complications but with a longer hospital stay. In 39 of the 42 patients (92%), good postoperative results were obtained. Only one case required a new surgery (22 months after the first one), due to recidivant cholangitis.Conclusion: Inadequate placement of the T tubes and long-term stay can produce complex biliary injuries with associated comorbidities such as fistulas to the adjacent viscera. Placement of T tubes need a careful surgical technique and their indication must be carefully assessed. |
| first_indexed | 2024-12-19T03:48:46Z |
| format | Article |
| id | doaj.art-c0f612e2d567416aac9a0f2798ae2d08 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-19T03:48:46Z |
| publishDate | 2006-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-c0f612e2d567416aac9a0f2798ae2d082022-12-21T20:37:04ZengElsevierAnnals of Hepatology1665-26812006-01-01514448Bile duct injuries related to misplacement of “T tubes”Miguel Ángel Mercado0Héctor Orozco1Alexandra Barajas Olivas2José Manuel Villalta3Ismael Domínguez4Javier Eraña5Fernando Poucel6Carlos ChanDepartment of Surgery. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”; Address for correspondence:Department of Surgery. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Department of Surgery. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Department of Surgery. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Department of Surgery. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Department of Surgery. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Department of Surgery. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Introduction: T tubes can be placed in the bile ducts either open or laparoscopically for several reasons such as: extraction of stones, biliary reconstruction after liver transplant and in end-to-end anastomosis in iatrogenic injuries. Inadequate placement of the T tube, long term stay and technical difficulties that can affect the outcome, can lead to an injury that usually requires a biliodigestive reconstruction.Methods: In a 15-year period (1990–2005) a total of 343 patients have been referred to our university hospital for biliary reconstruction. Files of those patients in which the injury was due to misplacement of a T tube or associated with a long-term stay were reviewed. We evaluated the type of injury, technique used for the reconstruction, longterm staying of the T tubes (1–6 months), hospital in stay, long term outcomes as well as associated comorbidities.Results: In 42 cases a biliary injury related to a T tube was identified (13%). All the injuries were classified as Strasberg E, with demonstration of a fistula (internal or external); 18 to the duodenum, 5 to the jejunum – ileum and 3 to the colon. A hepatojejunostomy was done to all patients; the duodenum and small gut fistulas were closed and in the 3 cases with colonic injury a right hemicolectomy was performed. The postoperative evolution was adequate without major complications but with a longer hospital stay. In 39 of the 42 patients (92%), good postoperative results were obtained. Only one case required a new surgery (22 months after the first one), due to recidivant cholangitis.Conclusion: Inadequate placement of the T tubes and long-term stay can produce complex biliary injuries with associated comorbidities such as fistulas to the adjacent viscera. Placement of T tubes need a careful surgical technique and their indication must be carefully assessed.http://www.sciencedirect.com/science/article/pii/S1665268119320393T tubebile duct injuries |
| spellingShingle | Miguel Ángel Mercado Héctor Orozco Alexandra Barajas Olivas José Manuel Villalta Ismael Domínguez Javier Eraña Fernando Poucel Carlos Chan Bile duct injuries related to misplacement of “T tubes” Annals of Hepatology T tube bile duct injuries |
| title | Bile duct injuries related to misplacement of “T tubes” |
| title_full | Bile duct injuries related to misplacement of “T tubes” |
| title_fullStr | Bile duct injuries related to misplacement of “T tubes” |
| title_full_unstemmed | Bile duct injuries related to misplacement of “T tubes” |
| title_short | Bile duct injuries related to misplacement of “T tubes” |
| title_sort | bile duct injuries related to misplacement of t tubes |
| topic | T tube bile duct injuries |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119320393 |
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