1. Indications for “T” duct drainage?
Extrahepatic bile duct dilatation.
intra- and extrahepatic bile duct stones.
Severe cholangitis.
obstructive jaundice
biliary pancreatitis.
Ascaris lumbricoides.
Tumors.
2, the purpose of biliary tract injury?
Removal of lesions.
Removal of stones.
To relieve obstruction.
To clear the drainage.
When in doubt, drain.
3.What are the main points to observe in the abdomen after the drainage of “T” tube?
Is there any abdominal pain?
Is there any abdominal distension?
Is there any pressure pain, rebound pain, muscle tension?
Is the bladder area full?
Is there any leakage of blood, fluid, ascites or bile?
Are the dressings clean? Is there any loosening?
Are the tubes and lap band fixed properly?
4, “T” tube drainage observation points?
Bile volume increase or decrease?
Is the color darkening or lightening?
Is there pus, blood, stone fragments, necrotic tissue, flocculent material, roundworm remains, live roundworms, etc.?
5.Pay attention to the drainage tube itself and surrounding conditions?
Is there any slippage?
Are there angles and deflation?
Is there any aging, breakage, fracture?
Are there any broken sutures?
Is there any pus, allergy?
Is there any biliary fistula, leakage of ascites?
6, jaundice observation points?
Skin and sclera yellowing?
Change of urine color?
The decrease of bilirubin in liver function?
7.Complications of “T” tube slippage?
Within 24h after surgery → immediate reoperation.
＞ 24h→ fine urinary drainage via fistula with peritonitis→ surgery.
> 1 week → observation, generally no special treatment is needed.
8.Complications of “T” duct blockage?
24h± possible no/very little bile drainage.
Blood clots, stones, roundworms, etc.
Low-pressure flushing with heparin saline/antibiotic solution.
Clamping of instruments.
9.Why is it difficult to pull out the “T” tube?
Mostly sutured “T” tubes.
Avoid violent extraction.
Repeated daily traction.
10.How long does it take to pull out the “T” tube?
About 2 weeks.
No fever and no abdominal pain before extraction.
Bile smear: no abnormality.
T-tube elevation, clamping and imaging without abnormalities for several days before extraction.
Short post-imaging period of openness, re-clamping or direct extraction.