Repair of common bile duct injury over a T-tube

A T-tube may be placed after laparoscopic or open common bile duct exploration. The largest-caliber T-tube the duct will accommodate should be selected. Tapering the ends of the T-tube catheter with scissors facilitates intraductal placement. In addition, opening the intraductal portion of the T-tube along its length opposite the junction of the intra-abdominal portion will allow the catheter to collapse when it is removed. The catheter should be secured in the bile duct using fine monofilament sutures, taking care not to suture into the catheter. A completion T-tube cholangiogram is performed prior to abdominal closure.