DEVELOPMENT OF T-TUBE TRACTS IN PIGLETS - EFFECT OF INSERTION METHOD AND MATERIAL OF T-TUBES

T-tube-related bile leakage is a considerable problem in liver transpl antation but rather rare in surgery of biliary lithiasis. To investiga te the effect of T-tube insertion method and material on the intraperi toneal T-tube tract, we performed a choledochotomy and insertion of a T-tube (four of silicone, seven of latex, four of silicone with a late x sheath around the long arm) for 2 weeks on 15 piglets (choledochotom y group), and sutured a transected bile duct over a T-tube stent in ni ne piglets (five silicone, four latex), inserted similarly as in liver transplantations, for 6 weeks. Sixteen patients underwent cholectocho tomy and T-tube drainage with a latex T-tube (n=8) and latex-sheathed silicone T-tube (n=8) for a median 9 (7-21) days. Histological examina tion of T-tube tracts in piglets was made, and complications after T-t ube removal in the latex T-tube group were compared with those in the latex-sheathed silicone T-tube group. In piglets, latex T-tubes induce d better tracts than silicone T-tubes (P < 0.05). Piglets in the chole dochotomy group had tracts superior to those in the anastomotic stent group (P < 0.05). There was one bile leakage in the latex T-tube group , and none in the latex-sheathed silicone T-tube group. We conclude th at T-tube tract development is affected by both the material and the i nsertion method of T-tubes. A silicone T-tube with a latex sheath arou nd the long arm may also be a good choice for T-tube material in liver transplantation.