Asian Journal of Case Reports in Surgery

Retained T-tube after CBD Exploration Extracted Laparoscopically: A Case Report

Arun Kumar Mohanty

Department of Endocrine Surgery, SCB Medical College and Hospital, Cuttack, India.

Sujit Kumar Mohanty

Department of Surgery, SCB Medical College and Hospital, Cuttack, India.

Ramapada Mohapatra

Department of Surgery, SCB Medical College and Hospital, Cuttack, India.

Suraj Ethiraj *

Department of Surgery, SCB Medical College and Hospital, Cuttack, India.

*Author to whom correspondence should be addressed.

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Abstract

Introduction: T-tube has long been used to drain the biliary tract after choledochotomy. It is generally removed 10-14 days after the surgery by means of gentle traction. Here we report a rare cause of retained T-tube due to plastering and peritonialisation of the tube to the parietal wall.

Case Report: A 45 year old lady with choledocholithiasis was planned for common bile duct (CBD) exploration and stone extraction after a failed ERCP. After the procedure a T-tube drain was placed in the CBD. On post operative day 21, the tube was unable to be removed despite traction. Patient was planned for a diagnostic laparoscopy which revealed that the T-tube was plastered and peritonialised completely along its tract to the parietal wall causing its retention. The tube was dissected from the sheath formed around and gently extracted uneventfully. The patient was later doing fine on regular follow up.

Conclusion: Although T-tube placement after choledochotomy is a common surgical practice, the complications of retained T-tube is less understood. Defining the various causes of retained T-tube helps in handling such complications.

Keywords: T-tube, CBD Exploration, laparoscopy, cholecystectomy, choledocholithiasis

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