Liu N, Zhang M, Guo Y, Bian J, Meng XK, Li J. Application of T-tube stent external drainage for the prevention of postoperative biliary stricture during choledochojejunostomy. World J Gastrointest Surg 2026; 18(3): 115888 [DOI: 10.4240/wjgs.v18.i3.115888]
Corresponding Author of This Article
Jun Li, MD, PhD, Adjunct Professor, Chief Physician, Department of Hepatobiliary, Pancreatic and Splenic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, No. 1 North Road, Huimin District, Hohhot 010000, Inner Mongolia Autonomous Region, China. ljdoctor1982@163.com
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Gastroenterology & Hepatology
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Retrospective Study
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Mar 27, 2026 (publication date) through Mar 30, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Liu N, Zhang M, Guo Y, Bian J, Meng XK, Li J. Application of T-tube stent external drainage for the prevention of postoperative biliary stricture during choledochojejunostomy. World J Gastrointest Surg 2026; 18(3): 115888 [DOI: 10.4240/wjgs.v18.i3.115888]
World J Gastrointest Surg. Mar 27, 2026; 18(3): 115888 Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.115888
Application of T-tube stent external drainage for the prevention of postoperative biliary stricture during choledochojejunostomy
Na Liu, Ming Zhang, Yan Guo, Jie Bian, Xing-Kai Meng, Jun Li
Na Liu, Ming Zhang, Jie Bian, Xing-Kai Meng, Jun Li, Department of Hepatobiliary, Pancreatic and Splenic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
Yan Guo, Department of General Surgery, Inner Mongolia Fourth Hospital, Hohhot 010000, Inner Mongolia Autonomous Region, China
Co-first authors: Na Liu and Ming Zhang.
Author contributions: Liu N was responsible for the study conceptualization and drafting the main body of the manuscript; Liu N and Zhang M contributed equally to this work as co-first authors; Zhang M was in charge of data acquisition, analysis of the manuscript data results, and preparation of tables and figures; Guo Y and Bian J contributed to methodology, validation and data curation; Meng XK contributed to supervision, methodology, resources and writing review and editing; Li J designed the study; all authors reviewed and approved the manuscript.
Supported by Major Project Funding of the Hohhot First Hospital, No. 2022SYY (ZD) 01; Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2023MS08056; Youth Innovation Team Project of the Affiliated Hospital of Inner Mongolia Medical University; and Inner Mongolia Medical University “Zhiyuan” Talent Program, No. ZY20242141.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of the Affiliated Hospital of Inner Mongolia Medical University, approval No. YJ2024055.
Informed consent statement: The requirement for written informed consent was not needed due to retrospective design of the study.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: The data involved in this study can be obtained from the corresponding author.
Corresponding author: Jun Li, MD, PhD, Adjunct Professor, Chief Physician, Department of Hepatobiliary, Pancreatic and Splenic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, No. 1 North Road, Huimin District, Hohhot 010000, Inner Mongolia Autonomous Region, China. ljdoctor1982@163.com
Received: October 29, 2025 Revised: November 27, 2025 Accepted: January 21, 2026 Published online: March 27, 2026 Processing time: 150 Days and 20.8 Hours
Abstract
BACKGROUND
Biliary stricture is a common complication after choledochojejunostomy (CJ). Inappropriate treatment affects the postoperative recovery of patients, and long-term biliary stricture may even impair liver function, seriously affecting the quality of life. Currently, many treatment methods for biliary stricture exist, but there are few reports on preventive measures for biliary stricture. Based on the clinical experience of our team in the field of CJ and a retrospective analysis of postoperative complications, we propose a modified technique involving the placement of a T-tube at the CJ site in cases of relatively stenotic or normal biliary tracts, with the aim of supporting the reconstructed biliary tract and thereby reducing the incidence of postoperative biliary stricture.
AIM
To evaluate the effectiveness of placing a T-tube at the CJ site to prevent postoperative biliary stricture during CJ.
METHODS
A single-center retrospective study was conducted, involving 68 patients with bile duct diameters < 8 mm who underwent biliary reconstruction surgery in the Department of Hepatobiliary and Pancreatic Surgery, the Affiliated Hospital of Inner Mongolia Medical University. Of these patients, 32 underwent T-tube stent external drainage at the CJ site (T-tube group), and 36 underwent conventional internal drainage of the CJ (non-T-tube group). The incidence of postoperative biliary stricture, biliary leakage and other postoperative complications was compared between the two groups.
RESULTS
There were no significant differences in age, sex, body mass index, American Society of Anesthesiologists class, preoperative laboratory indices, preoperative hypertension, diabetes history or pathology findings between the two groups. The incidence of postoperative biliary stricture and biliary leakage in the T-tube group was lower than that in the non-T-tube group; in addition, the operation time, intraoperative blood loss and hospital stay in the T-tube group were lower than those in the non-T-tube group. There was no significant difference in postoperative complications such as abdominal infection, pulmonary infection or delayed gastric emptying between the two groups.
CONCLUSION
The modified T-tube stent external drainage technique effectively reduces the incidence of postoperative biliary stricture, has certain advantages in reducing postoperative biliary leakage, and is worthy of clinical promotion and application.
Core Tip: In this study, a modified choledochojejunostomy (CJ) technique was proposed. A T-tube was placed at the CJ site to support the reconstructed biliary tract, and external drainage was performed during CJ, which effectively reduced the incidence of postoperative biliary stricture. Compared with traditional internal drainage of the CJ, the incidence of biliary complications such as post-operative biliary leakage was significantly lower, length of hospital stay was reduced and patient postoperative quality of life was greatly improved. This technique has high clinical value and is worthy of clinical promotion and application.
