T tube sinus tract duodenal fistula: a rare complication of postoperative choledochoscopy for treating retained intrahep
- PDF / 1,085,067 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 13 Downloads / 194 Views
and Other Interventional Techniques
T tube sinus tract duodenal fistula: a rare complication of postoperative choledochoscopy for treating retained intrahepatic stones Jianying Lou1 · Hua Zhao1 · Wei Chen1 · Ji Wang1 Received: 19 November 2019 / Accepted: 29 September 2020 © The Author(s) 2020
Abstract Backgrounds Postoperative percutaneous choledochoscopy via T tube sinus tract is a common modality for treating retained intrahepatic stones in China. We report a rare complication of postoperative choledochoscopy for treating retained hepatolithiasis: T tube sinus tract duodenal fistula. Methods From January 2003 to December 2018, intrahepatic duct stones with or without common bile duct stones were detected in 1031 patients. Fifteen of the 1031 patients with intrahepatic stones developed a T tube sinus tract duodenal fistula that was diagnosed by cholangiography and choledochoscopy. Results The incidence of T tube sinus tract duodenal fistula in patients with retained intrahepatic stones being treated by postoperative choledochoscopy is 1.45% (15/1031) in this series. The chi-squared test showed that hypoalbuminemia (P = 0.003), long duration of T tube (P = 0.002), and high frequency of procedure (P = 0.008) might be associated with the occurrence of T tube sinus tract duodenal fistula. The logistic regression analysis demonstrated that hypoalbuminemia might be the independent risk factor for this special fistula (P = 0.037). Conclusions Hypoalbuminemia, long time placement of T tube in situ and high frequency of procedure are probably the main causes of the T tube sinus tract duodenal fistula. Placement of T tube in correct way and improving nutritional status may be the key points to prevent the formation of T tube sinus tract duodenal fistula. Keywords Intrahepatic stones · Choledochoscopy · T tube sinus tract · Duodenum · Fistula Hepatolithiasis or intrahepatic duct stones is prevalent in East Asia [1, 2]. In addition to choledochoscopy, various lithotripsy techniques and liver resection were widely used for treatment of intrahepatic duct stones, the clearance rate of intrahepatic stones has increased in recent years [3, 4]. Postoperative percutaneous choledochoscopy via the T tube sinus tract is a safe and effective approach for treating retained or residual intrahepatic stones [5]. The complications of percutaneous choledochoscopy such as fever (cholangitis), biliary duct bleeding, and T tube inadvertently dislodgement are usually mild and not life threatening. However, some rare complications related to percutaneous
choledochoscopy are serious and may result in failure of retained stones extraction [6]. T tube sinus tract duodenal fistula due to long-term placement of T tube is a rare complication of postoperative percutaneous choledochoscopy that can lead to occlusion of distal channel of primary T tube sinus tract and failure to reach biliary duct for stones extraction. Here, we reported 15 cases of T tube sinus tract duodenal fistula that had not been described systematically by other authors.
Data Loading...
