Removing a biliary T-tube and retained stones by ERCP. A case report

A time-honored praxis is to insert a T-tube after open choledochotomy. Well-known complications of T-tube removal include bile leakage, peritonitis, sepsis and postoperative biliary stenosis. A retained T-tube fragment after surgical common bile duct exploration is an uncommon complication of T-tube removal. We report the first case of retained bile duct stones with a whole T-tube jammed into the biliary tree. A 31-year-old female with gallstone disease was operated on. The operation was started by laparoscopy but converted to open laparotomy because of perforation of the gallbladder. T-tube was inserted but several stones remained in the bile duct. Afterwards routine T-tube removal was impossible: the T-tube had become trapped in the common bile duct. This combination of complications was successfully treated by ERCP.