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

INTRODUCTION

Laparoscopic T-tube insertion into common bile duct (CBD) can be technically challenging. We describe a technique to facilitate CBD T-tube placement.

METHOD

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.

SYNOPSIS

Laparoscopic placement of T-tube in CBD can be safely and easily manipulated in the described technique.