T tubes can be placed in the bile ducts either open or laparoscopically for several reasons such as: extraction of stones, biliary reconstruction after liver transplant and in end-to-end anastomosis in iatrogenic injuries. Inadequate placement of the T tube, long term stay and technical difficulties that can affect the outcome, can lead to an injury that usually requires a biliodigestive reconstruction.In a 15-year period (1990-2005) a total of 343 patients have been referred to our university hospital for biliary reconstruction. Files of those patients in which the injury was due to misplacement of a T tube or associated with a long-term stay were reviewed. We evaluated the type of injury, technique used for the reconstruction, longterm staying of the T tubes (1-6 months), hospital in stay, long term outcomes as well as associated comorbidities.In 42 cases a biliary injury related to a T tube was identified (13%). All the injuries were classified as Strasberg E, with demonstration of a fistula (internal or external); 18 to the duodenum, 5 to the jejunum-ileum and 3 to the colon. A hepatojejunostomy was done to all patients; the duodenum and small gut fistulas were closed and in the 3 cases with colonic injury a right hemicolectomy was performed. The postoperative evolution was adequate without major complications but with a longer hospital stay. In 39 of the 42 patients (92%), good postoperative results were obtained. Only one case required a new surgery (22 months after the first one), due to recidivant cholangitis.Inadequate placement of the T tubes and long-term stay can produce complex biliary injuries with associated comorbidities such as fistulas to the adjacent viscera. Placement of T tubes need a careful surgical technique and their indication must be carefully assessed.

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longterm staying injury technique endtoend anastomosis tube of stones biliary reconstruction tubes

Miguel, Angel Mercado Carlos, Chan Héctor, Orozco Alexandra, Barajas Olivas José Manuel, Villalta Ismael, Domínguez Javier, Era?a Fernando, Poucel,.Bile duct injuries related to misplacement of "T tubes".. 5 (1),44-8.

Miguel, Angel Mercado Carlos, Chan Héctor, Orozco Alexandra, Barajas Olivas José Manuel, Villalta Ismael, Domínguez Javier, Era?a Fernando, Poucel,"Bile duct injuries related to misplacement of "T tubes"." 5

Miguel, Angel Mercado Carlos, Chan Héctor, Orozco Alexandra, Barajas Olivas José Manuel, Villalta Ismael, Domínguez Javier, Era?a Fernando, Poucel,"Bile duct injuries related to misplacement of "T tubes"."