Pediatric T-tube in adult liver transplantation: Technical refinements of insertion and removal

Figure 1 T-tube insertion protocol. A: The right-angle is advanced through the open anterior layer of the duct-to-duct anastomosis and a choledochotomy is created with a no. 11 scalpel; B-D: A silk tie is grabbed and pulled through the choledochotomy after being stitched to the horizontal end of the T-tube; E: the T-tube is allocated inside the bile duct; F: the anastomosis is completed with interrupted Vicryl 6/0 stitches.

Figure 2 Bedside, standard T-tube removal procedure. A: The T-tube is removed; B: A Nelaton drain is kept aside to measure the length of the T-tube internal tract (whiter portion of the T-tube); C: The Nelaton drain is inserted approximately 2 cm shorter than the measured length.