Stent Beats T-Tube After Duct Exploration
For decades the T-tube was the default answer to “how do we protect the duct after exploration?” Rudiman and colleagues’ meta-analysis of 16 studies (1,080 patients) makes a strong case that its era is ending. Compared with T-tube drainage, internal biliary stenting after common bile duct exploration reduced overall postoperative complications by more than half (RR 0.43, 95% CI 0.23-0.80), shortened hospital stay by approximately two days, shortened operative time, and reduced readmissions (RR 0.39). Bile leak, wound infection, and pancreatitis were no different. Internal drainage keeps bile where it belongs, spares patients weeks of external tube care, and sends them home sooner with fewer problems.
Citation
Rudiman R, Hanafi RV, Almawijaya, Halim F. Complications of biliary stenting versus T-tube insertion after common bile duct exploration: a systematic review and meta-analysis. PLoS One. 2023;18(1):e0280755. doi:10.1371/journal.pone.0280755
