TECHNIQUE FOR REDUCTION OF BILE PERITONITIS AFTER T-TUBE REMOVAL IN LIVER-TRANSPLANT PATIENTS

PURPOSE: The purpose of this work was to evaluate the incidence of bil e peritonitis following T-tube removal in liver transplant patients as a function of the method of T-tube removal. Removal at the bedside wa s compared to removal in the interventional radiology department with subsequent placement of a temporary drainage catheter, MATERIALS AND M ETHODS: From June 1987 through July 1993, 1,105 patients underwent ort hotopic liver transplantation at the UCLA Medical Center. Three hundre d patients were randomly selected from this group and their charts wer e reviewed. Two hundred sixty-three patients who had choledocho-choled ochostomies over a T tube, and adequate documentation of the method of T-tube removal and subsequent clinical course were included in the st udy. Forty-one patients had their drainage catheter removed at the bed side, and 222 patients had their T-tube removed over a wire in the int erventional radiology department with subsequent placement of a tempor ary drainage catheter. RESULTS: Among all patients included in this st udy, 10.3% had bile peritonitis, Of the patients who had their T-tube removed at the bedside, 19.5% had bile peritonitis, whereas only 8.6% of the patients who had their T-tube removed in the interventional rad iology department had bile peritonitis, This result is statistically s ignificant (P < .05). CONCLUSION: Placing a temporary drain at the tim e of T-tube removal in the interventional radiology department results in a significant reduction in the incidence of bile peritonitis in li ver transplant patients. The procedure is relatively simple, quickly m astered, and well tolerated by patients.