Aman of 70 years DM, Hypertension and CAD had CBD partial injury(3/4 of circumference) during a difficult lap chole with frozen callots.No energy source was used.Corners were secured with 4o prolene and an antigrade stenting was attemted with 10 f Amsterdam stent.It was not successful as the division was on the CHD as the flaps were coming out through the defect despite several attepmts to place it.Hence a 12 f T-tube was placed and the CBD was repaired well.No leak of bile post operatively.The recovery of the of the patient was uneventful.Tube drain in the sub hepatic space was removed on 4th post op day and pt was discharged.T-tube out put is around 300mls in 24 hours.
Sir , follow the classical approach, wait for 4 weeks atleast before considering ERCP
Dear Fellow,
I agree with my colleagues from the point of waiting at least 4/52 , and perform a contrast medium X ray injected through T tube to make sure that no leak present , if this is the case you can start clamping T tube intermittently , however it is quite recommended to do ERCP and sphincterotomy from now .
