With the improvement of living standards, the incidence of gallbladder stones is increasing, and the number of patients with bile duct stones is also increasing day by day. After choledochotomy, doctors often place a medical silicone T-tube in the patient. Many patients have some doubts about what is a medical silicone T-tube. What are the key points of care for medical silicone T-tube drainage? When is a medical silicone T-tube removed?
What is a medical silicone T-tube?
In patients with biliary tract disease, a “T”-shaped tube is placed at the common bile duct incision after surgery, with one end leading to the hepatic duct and one end leading to the duodenum, which is pierced out of the body by the abdominal wall and connected to a drainage bag for drainage of bile.
The purpose of placing medical silicone T-tube after surgery
(1) Drainage of bile.
(2) Drainage of residual stones, especially sediment-like stones; postoperative lithotripsy and angiography can also be performed through the medical silicone T-tube.
(3) Support the bile duct: to avoid postoperative scar narrowing of the common bile duct incision, small lumen, adhesion narrowing, etc.
What are the complications of medical silicone T-tube drainage?
Medical silicone T-tube drainage often has some complications due to various reasons, such as medical silicone T-tube dislodgement, medical silicone T-tube blockage, retrograde infection, biliary fistula, etc., which affect the recovery of patients.
Care points of medical silicone T-tube drainage
(1) Keep the drainage unobstructed, do not fold, do not block, and should be properly fixed to avoid dislodgement and prevent retrograde flow and infection.
(2) Shower should be used when bathing and cover the drainage wound with plastic film, and the dressing should be changed in time to prevent infection when it is wet.
(3) Avoid spicy and oily food during the period of tube.
(4) Strengthen the protection of the skin at the drainage tube, if there is bile leakage, the dressing should be changed in time, and the surrounding skin should be protected with zinc oxide ointment to prevent erosion and infection.
(5) Observe the color, amount and nature of drainage fluid. The drainage flow within 24h after surgery is about 300~500mL, after eating, it can be increased to 600~700mL per day, and then gradually reduced to about 200mL per day. The bile is cloudy and yellowish for 1~2 days after surgery, and then gradually deepens, clear and yellow. If abnormalities occur, they should be reported to the doctor in time.
(6) Change the drainage bag regularly.
(7) When there is fever, nausea, vomiting, abdominal pain, abdominal distension, etc., or if the patient’s jaundice increases, the medical silicone T-tube should be released in time and the doctor should be reported in time.
Medical silicone T-tube removal of care points
The patient has no fever, no abdominal pain, jaundice subsides, serum jaundice index is normal, bile drainage is reduced to 200mL, clear, cholangiogram confirms bile duct patency, and no discomfort from the clamping test can be considered for extubation.
The drainage tube should be opened for 2~3 days before extubation so that the contrast agent can be completely excluded. After extubation, observe whether the patient has abdominal pain, abdominal distension, nausea, vomiting, fever and jaundice, a small amount of bile leaking from the simple wound, change the dressing in time, and it can stop on its own within 1~2 days.
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