1. T tube drainage for spontaneous perforation of the extrahepatic bile duct
- Author
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Osamu Komine, Masanori Watanabe, Masanori Yoshino, Hideyuki Suzuki, Masao Ogata, Arichika Hoshino, Kentaro Maejima, Aki Yagi, Satoshi Mizutani, Akira Tokunaga, and Eiji Uchida
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Spontaneous Perforation ,T tube drainage ,digestive system ,Bile Ducts, Extrahepatic ,Laparotomy ,medicine ,Humans ,Cholecystectomy ,Aged ,Case Study ,Rupture, Spontaneous ,business.industry ,Bile duct ,General Medicine ,Hepatic bile ,preoperative diagnosis ,medicine.anatomical_structure ,Drainage ,Female ,Radiology ,business ,spontaneous perforation of the bile duct ,Duct (anatomy) - Abstract
Summary Background Spontaneous perforation of the extrahepatic bile duct is very rare. We report a patient with a spontaneous perforation of the left hepatic bile duct who was diagnosed preoperatively. Case Report A 65-year-old woman was admitted to our hospital complaining of a right upper quadrant pain lasting for two days. She was diagnosed as having a perforated bile duct and peritonitis and underwent a laparotomy. After a cholecystectomy, T-tube drainage of the left hepatic duct was performed. The postoperative course was uneventful. The T tube was removed 25 days after the surgery. Conclusions A more noninvasive procedure, such as endoscopic treatment, should play a central role in the management of extra bile duct perforation. For this case, however, we chose to perform a laparotomy based on the patient’s general condition and the presence of peritonitis. T tube decompression is effective and a safe and reliable method. The goal of treatment is to stop the bile leakage, resolve the choledocholithiasis and cholangitis, and reconstruct the bile duct.
- Published
- 2011
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