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T-tube bridging for the management of biliary tree injuries

Aydemir Olmez, Sinan Hatipoglu, Veyis Itik, Cetin Kotan

Am J Case Rep 2012; 13:247-249

DOI: 10.12659/AJCR.883499

Published: 2012-10-05


Background:    Injuries of the biliary tree, which mainly occur as a complication of laparoscopic cholecystectomy, are a potentially life threatening cause of high morbidity and mortality. The reported frequency of biliary injuries after laparoscopic cholecystectomy is from 0.5–0.8%. Such injuries may sometimes become too complicated for surgical repair. Presented here is the case of a patient with a major bile duct injury for whom bile duct continuity was achieved using a T-tube.
    Case Report:    A 53-year-old man, who developed bile duct injury following a laparoscopic cholecystectomy performed in another center for cholelithiasis, was referred to our clinic. A Roux-en-Y hepaticojejunostomy was performed in the early postoperative period. However, ensuing anastomotic leakage prompted undoing of the hepaticojejunostomy followed by placement of a T-tube by which bile duct continuity was achieved.
    Conclusions:    For injuries with tissue loss requiring external drainage, T-tube bridging offers a feasible option in that it provides bile duct continuity with biliary flow into the duodenum, as well as achieving external drainage, thus alleviating the need for further definitive surgery.

Keywords: iatrogenic bile duct injury, T-tube bridging, external and internal biliary drainage



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