Biliary peritonitis requiring reoperation after removal of T-tubes from the common bile duct

Abstract

Background: Bile. peritonitis can occur when a T-tube is electively removed from the common bile duct, but this is regarded as a rare complication. Plastic T-tubes are known to increase this risk and should not be used. Latex rubber T-tubes are preferred, but the peritonitis, can still occur. Methods: Prospective data were collected on 1375 patients who underwent common bile duct exploration between March 20, 1,994 and March 20, 2003. Results: Thirty-four (2.47 %) patients experienced generalized bile peritonitis after T-tube removal from the common bile duct. Mean age was 63.65 years. In all cases, a soft silicon-coated latex rubber T-tube was placed into the bile duct. All T-tubes were removed 21 days after surgery. Thirty-four patients developed acute generalized biliary peritonitis immediately after T-tube removal and required urgent active intervention. The mortality rate was 5.9 %, and the mean hospital stay was 14.6 days. Conclusions: The most common causes of lack of formation of T-tube tract and operative procedure were unknown and T-tube reinsertion, respectively. T-tube removal can result in significant morbidity and mortality. (c) 2005 Excerpta Medica Inc. All rights reserved.