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August 27, 1973

The T-Tube

Author Affiliations

Hahnemann Hospital Worcester, Mass

JAMA. 1973;225(9):1120. doi:10.1001/jama.1973.03220370058020

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To the Editor.—  Your recent EDITORIAL "T-Tube: To Use or Not To Use" (224:1644, 1973), implies that a T-Tube is only a pacifier for the surgeon who may have left a stone in place. Unfortunately, even though preoperative and intraoperative cholangiography is performed almost routinely in most medical centers today, retained common duct stones are still a problem. Many of these lie within intrahepatic ducts at the time of surgery, and often these ducts are not filled at the time of operative cholangiography.Recent development of a guidable catheter system now allows extraction of retained common duct stones postoperatively without surgery. This procedure can only be performed if a T-Tube has been left in place in the common duct so a fistulous tract is open.Whether or not the T-Tube is only a pacifier for the surgeon is inconsequential, but the T-Tube certainly offers the patient excellent insurance for not requiring