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August 27, 1973

The T-Tube

Author Affiliations

Oyster Bay, NY

JAMA. 1973;225(9):1120. doi:10.1001/jama.1973.03220370058021

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To the Editor.—  He asks: "Would not many surgeons agree with this conclusion?" Reference was made to preoperative and intraoperative cholangiography which would eliminate the need for re-exploration of the common bile duct, negating thereby the insertion of a T tube. To answer the question with a simple yes or no is reminiscent of the attorney-at-law demanding a yes-or-no answer from a physician defendant or an expert medical witness. The answer may be yes with an explanation.Primary closure of the common bile duct is not of new vintage. Frank Lahey performed this procedure as did other members of his surgical staff many years ago. When the surgeon considers the elimination of T tube insertion into the common bile duct, thought must be given to the underlying disease for which the duct exploration was performed. For example, in the presence of primary cancer of the bile ducts, with stricture or