Biliary peritonitis requiring reoperation after removal of T-tubes from the common bile duct

Background Bile peritonitis can occur when a T-tube is electively removed from the common bile duct, but this is regarded as a rare complication. Plastic T-tubes are known to increase this risk and should not be used. Latex rubber T-tubes are preferred, but the peritonitis can still occur. Methods Prospective data were collected on 1375 patients who underwent common bile duct exploration between March 20, 1994 and March 20, 2003. Results Thirty-four (2.47%) patients experienced generalized bile peritonitis after T-tube removal from the common bile duct. Mean age was 63.65 years. In all cases, a soft silicon-coated latex rubber T-tube was placed into the bile duct. All T-tubes were removed 21 days after surgery. Thirty-four patients developed acute generalized biliary peritonitis immediately after T-tube removal and required urgent active intervention. The mortality rate was 5.9%, and the mean hospital stay was 14.6 days. Conclusions The most common causes of lack of formation of T-tube tract and operative procedure were unknown and T-tube reinsertion, respectively. T-tube removal can result in significant morbidity and mortality.