Laparoscopic T-tube placement after common bile duct exploration: a simple technique. 2009

Pradeep Kumar, and Mavis Orizu, and Edmund Leung
Department of General Surgery, Queen's Hospital, Burton, UK.

BACKGROUND Laparoscopic T-tube insertion into common bile duct (CBD) can be technically challenging. We describe a technique to facilitate CBD T-tube placement. METHODS The T-limb was cut to appropriate size and guttered along one-third of its circumference lengthwise. One end of T-limb was secured to the long stem using a tie. The free end was introduced into the abdomen through the epigastric port. Using nontraumatic graspers, this free end was advanced into the CBD. Once the whole of T-limb was inside, the tie was cut, and the T-tube would spring into place. Choledochotomy was sutured snugly around the T-tube. The long limb was taken out through the lateral port of the abdominal wall. RESULTS There was no dislodgment or removal difficulty in all cases. This manoeuvre required <1 minute. CONCLUSIONS This technique allows reliable and easier T-tube placement into CBD, requiring no ancillary devices. It shortens the steep learning curve. CONCLUSIONS Laparoscopic placement of T-tube in CBD can be safely and easily manipulated in the described technique.

UI MeSH Term Description Entries
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D002768 Choledochostomy Surgical formation of an opening (stoma) into the COMMON BILE DUCT for drainage or for direct communication with a site in the small intestine, primarily the DUODENUM or JEJUNUM. Choledochoduodenostomy,Choledochojejunostomy,Choledojejunostomies,Choledochoduodenostomies,Choledochojejunostomies,Choledochostomies,Choledojejunostomy
D003135 Common Bile Duct The largest bile duct. It is formed by the junction of the CYSTIC DUCT and the COMMON HEPATIC DUCT. Choledochus,Bile Duct, Common,Common Bile Ducts,Duct, Common Bile
D003137 Common Bile Duct Diseases Diseases of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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