Prevention of Biliary Leakage after Removal of T-tube in Immunocompromised Patients.

Biliary leakage after T-tube removal is an important complication which can be lethal especially in patients who received immunosuppressant agents. The purpose of the study is to determine a method which can evaluate the completion of tract formation in high-risk patients. Participants include 46 patients who were candidates for open cholecystectomy and common bile duct (CBD) exploration and T-tube insertion. Twelve of patients received corticosteroids and were divided into two groups. In the first group, T-tube was removed conventionally, but in the other group, we performed a "fistulography" 1 month postoperative to evaluate maturity of tract between CBD and the skin. Biliary peritonitis was seen in half of patients who are managed conventionally, but no complication was detected in patients who underwent fistulography. Fistulography is suggested to be done before T-Tube removal in immunocompromised patients in order to detect tract formation, which is effective in reduction of postremoval complications.