During followup period, T-tube cholangiogram
revealed CBD stricture with two limbs of T-tube across the stricture.
Imaging modalities to diagnose, detect level, and follow-up of cases of BDI and bile leak (BL) were ultrasonography (USG), computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP), and T-tube cholangiogram.
T-tube cholangiogram was done in patient of end-to-end anastomosis repair over T-tube on 14th postoperative day.
With the high index of suspicion for the presence of an aberrant biliary anatomy and since all other relevant studies such as T-tube cholangiogram
and ERCP have already proven to be non-helpful, a cholangiogram through J-P drain was performed.
For open surgery with T-tube closure; discharge was done after the 10th day T-tube cholangiogram
was negative for stones and dye in the duodenum was present.
Post-operative T-tube cholangiogram
[Fig-9, 10] to visualize CBD for residual stones if any.
This line of management continued until the effluent from each subhepatic drain was less than 50mls daily and/or when T-tube cholangiograms
done on the 10th post-operative day showed flow of contrast into the duodenum and no evidence of retained stones.