[The C tube in biliary surgery--its development and clinical application]

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Procedures
• Gastroenterology

Context:

• The traditional T tube for bile drainage post-biliary surgery has limitations including high complication rates and prolonged hospitalization.
• Alternative methods like PTGBD, PTBD, and ENBD have not fully replaced the T tube.
• A novel C tube (cystic duct tube) has been developed for bile drainage via the cystic duct into the common bile duct.

Purpose:

• To assess the safety and benefits of the C tube procedure in biliary surgery.
• To compare the C tube method with the conventional T tube procedure regarding complications, drainage, and hospital stay.
• To evaluate the C tube's utility in detecting and managing remnant common bile duct stones.

Summary:

• The C tube procedure demonstrated zero major complications in 335 cases, with significantly lower minor complication rates compared to the T tube (0% vs. 21%).
• Patients undergoing the C tube procedure experienced significantly shorter drainage periods (5.9 days vs. 27.7 days) and hospital stays (11.6 days vs. 45.0 days).
• The C tube effectively detected remnant common bile duct stones, facilitating non-surgical management through techniques like sphincter of Oddi relaxation or endoscopic interventions.

Impact:

• The C tube procedure presents a safer and more efficient alternative to the T tube, potentially improving patient outcomes and reducing healthcare costs.
• This technique offers versatility, serving not only for bile drainage but also for remnant stone management and other biliary applications.
• Widespread adoption of the C tube could lead to a paradigm shift in postoperative bile drainage management, replacing the long-standing T tube method.