BILE LEAK AFTER T-TUBE REMOVAL - A SCINTIGRAPHIC STUDY

Background/Aims: A prospective study was performed to evaluate the inc idence of bile leak after T-tube removal, using Tc-99m labelled BULIDA scintigraphy. Patients and Methods: Thirty seven patients with choled ocholithiasis underwent choledocholithotomy and T-tube drainage. T-tub es were removed on. 9-26 postoperative day (mean 13.4 days). Results: Six (16%) patients had scintigraphic evidence of bile Leak; 4 patients had leak demonstrated in the early phase only. One patient each had p artial persistent leak and complete bile leak. All patients were manag ed nonsurgically; conservative treatment: (4), percutaneous drainage ( PCD) of intra-abdominal collection (1) and endoscopic sphincterotomy a nd PCD of intraabdominal collection (1). There was no significant diff erence in the Leak rate when T-tubes were removed at <2 weeks versus l ater than 2 weeks (P=.97). Conclusions: T-tubes should be removed with extreme caution and treatment of symptomatic patients should be guide d by clinical and scintigraphic findings.