A case of T-tube dislocation

In environments where endoscopic retrograde cholangio-pancreatogram (ERCP) services may at time be limited or unavailable, the surgeon must also decide between the insertion of a conventional T-tube or primary choledochorrhaphy when it is operatively perceived that the common bile duct (CBD) has been adequately cleared. Where the hospital stay of the patients with a T-tube in situ is prolonged, there is a higher incidence of postoperative bacteraemia with a moderate morbidity from biliary leakage after T-tube withdrawal. We report here a case as well as methods designed to prevent tube dislocation and alternatives to T-tube insertion after choledochotomy, whether performed open or laparoscopically.