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Iatrogenic bile duct Injury with a retained T-tube in common bile duct for 10 years: A case report
RATIONALE: Bile duct injury (BDI), a major complication of cholecystectomy, usually needs hepaticojejunostomy or primary repair over T-tube in severe cases. There were few cases about retained fragments of T-tube. Whereas, intact T-tube retained in common bile duct (CBD) for years after BDI was very...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485887/ https://www.ncbi.nlm.nih.gov/pubmed/30985676 http://dx.doi.org/10.1097/MD.0000000000015127 |
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author | Wang, Li Dong, Ping Zhang, Yi Liu, Xubao Tian, Bole |
author_facet | Wang, Li Dong, Ping Zhang, Yi Liu, Xubao Tian, Bole |
author_sort | Wang, Li |
collection | PubMed |
description | RATIONALE: Bile duct injury (BDI), a major complication of cholecystectomy, usually needs hepaticojejunostomy or primary repair over T-tube in severe cases. There were few cases about retained fragments of T-tube. Whereas, intact T-tube retained in common bile duct (CBD) for years after BDI was very rare. PATIENT CONCERNS: A 55-year-old female complaining of a retained T-tube in the right upper quadrant for 10 years with bilious exudation for 3 months. DIAGNOSIS: Based on the medical history of reoperation after the initial laparoscopic cholecystectomy (LC), the retained T-tube, the bilious exudation, and the feature of image modalities, she was diagnosed with retained biliary T-tube, biliary leak, hepatolithiasis, and BDI. INTERVENTIONS: After nonsurgical management at local hospitals, the patient had her indwelling T-tube removal during laparotomy in our center finally. During this procedure, bile duct exploration, hilar bile ducts reconstruction, and primary Roux-en-Y hepaticojejunostomy were performed. OUTCOMES: Unfortunately, bile leakage occurred postoperatively. After drainage of the peritoneal bilious fluid, the patient recovered gradually without further complication. LESSONS: T-tube in CBD could act as nidus for stone formation after long-time placement. As a result of gradual stone formation on T-tube, severe hepatic ducts dilatation may occur without the presence of jaundice. Timely follow-up and proper surgical intervention should be suggested for patients with T-tube placement or iatrogenic BDI to avoid further impacts. |
format | Online Article Text |
id | pubmed-6485887 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-64858872019-05-29 Iatrogenic bile duct Injury with a retained T-tube in common bile duct for 10 years: A case report Wang, Li Dong, Ping Zhang, Yi Liu, Xubao Tian, Bole Medicine (Baltimore) Research Article RATIONALE: Bile duct injury (BDI), a major complication of cholecystectomy, usually needs hepaticojejunostomy or primary repair over T-tube in severe cases. There were few cases about retained fragments of T-tube. Whereas, intact T-tube retained in common bile duct (CBD) for years after BDI was very rare. PATIENT CONCERNS: A 55-year-old female complaining of a retained T-tube in the right upper quadrant for 10 years with bilious exudation for 3 months. DIAGNOSIS: Based on the medical history of reoperation after the initial laparoscopic cholecystectomy (LC), the retained T-tube, the bilious exudation, and the feature of image modalities, she was diagnosed with retained biliary T-tube, biliary leak, hepatolithiasis, and BDI. INTERVENTIONS: After nonsurgical management at local hospitals, the patient had her indwelling T-tube removal during laparotomy in our center finally. During this procedure, bile duct exploration, hilar bile ducts reconstruction, and primary Roux-en-Y hepaticojejunostomy were performed. OUTCOMES: Unfortunately, bile leakage occurred postoperatively. After drainage of the peritoneal bilious fluid, the patient recovered gradually without further complication. LESSONS: T-tube in CBD could act as nidus for stone formation after long-time placement. As a result of gradual stone formation on T-tube, severe hepatic ducts dilatation may occur without the presence of jaundice. Timely follow-up and proper surgical intervention should be suggested for patients with T-tube placement or iatrogenic BDI to avoid further impacts. Wolters Kluwer Health 2019-04-12 /pmc/articles/PMC6485887/ /pubmed/30985676 http://dx.doi.org/10.1097/MD.0000000000015127 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article Wang, Li Dong, Ping Zhang, Yi Liu, Xubao Tian, Bole Iatrogenic bile duct Injury with a retained T-tube in common bile duct for 10 years: A case report |
title | Iatrogenic bile duct Injury with a retained T-tube in common bile duct for 10 years: A case report |
title_full | Iatrogenic bile duct Injury with a retained T-tube in common bile duct for 10 years: A case report |
title_fullStr | Iatrogenic bile duct Injury with a retained T-tube in common bile duct for 10 years: A case report |
title_full_unstemmed | Iatrogenic bile duct Injury with a retained T-tube in common bile duct for 10 years: A case report |
title_short | Iatrogenic bile duct Injury with a retained T-tube in common bile duct for 10 years: A case report |
title_sort | iatrogenic bile duct injury with a retained t-tube in common bile duct for 10 years: a case report |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485887/ https://www.ncbi.nlm.nih.gov/pubmed/30985676 http://dx.doi.org/10.1097/MD.0000000000015127 |
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