T Tube (Kehr’s Type) Drainage in Post surgery

The flexible tube made of latex along a vertical limb and a short horizontal limb. Kehr’s T tube is used for short-term postoperative drainage of a common bile duct. Placed in the common bile duct after cholecystectomy removal of gallbladder or choledochostomy helps in draining of bile duct. Used for t tube cholangiogram.

T tube cholangiogram -How to use

An incision is made on the common Bile Duct, insert the T shape tube into CBD, and closed with the Absorbable Suture. Another end of the Tube, connected to the Sterile Container to collect the fluids.  When drainage of bile common bile duct to the duodenum blocking the gallbladder stone and biliary fluids. The presence of the tube may prevent peritonitis due to leakage in case of residual stones blocking the lower end of the CBD

clamping of tube take place before and after taking of feeds either by oral or Nasogastric tube. while removing tube clamp the tube and then remove.

Choledochotomy by either open or laparoscopy tube placed in the common bile duct for T tube cholangiography. T tube cholangiography removed postoperatively for the confirmation of residual stone. Postoperative X-ray shows the residual stones left and extracted by the t tube placed after 4-6 weeks of surgery.

T tube drain used for the removal of common bile duct stone, postoperatively.  Drainage of CBD stones along with bile.

Then adjust the length of the tube with the help of Robert’s artery forceps for insertion. The limb of the tube is threaded for the proper insertion of the tube. After insertion of the tube check for proper drainage

The common bile duct closed with the absorbable suture. Make sure that no leakage after insertion.

Obstruction of drainage

Obstruction of bile flow Signs areT Tube

Fever

Tachycardia

Pain in the abdomen

Nausea

Right upper quadrant fullness

Jaundice

Dark foamy urine

Material 

Manufactured from soft non-toxic, medical-grade PVC compound.
The radio-opaque line- provided throughout the tube for X-ray visualization.
Super smooth tube surface prevents clogging.
Sterile, Individually packed in peelable pouch pack

SILICONE Types 

T-Tubes used in a variety of medical applications, including microsurgery, for supplying blood during anastomosis. 

Available in either clear silicone rubber or barium ‘ impregnated silicone rubber construction. The standard size has 12″ long branches with the intersection coming at the mid-way point on the top branch. Legs are of the equal lumen and outside diameters. 

Sizes
10 FG
12 FG
14 FG
16 FG
18 FG

Removal of the T Tube

After 7-10 days of the insertion,

Kehr’s T Tube cholangiogram is done and removed with a gentle pull.

The Dye flows freely into the duodenum.

No filling defects in the CBD.

After clamping the tube for 24 hours, there is no abdominal pain or fever.

There is no differentiation in the stool( normal stool color).

Contraction of the Fibrous tract will help to stop leakage of the biliary leak.

#ttube #choledochostomy #kehr’stube #ttubedrain 

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