To investigate the efficacy and safety of using guide wire to adjust the position of abnormal T-tube and replacing biliary drainage tube in the treatment of bile leakage after hepatobiliary surgery.

Retrospective analysis was performed on 4 patients with bile leakage after hepatobiliary surgery who were treated by T-tube adjustment and secondary biliary drainage tube placement under the guidance of DSA in Xiang Zhou District People's Hospital from January 2018 to January 2020. The guide wire and catheter were introduced through the T-tube, and the guide wire and catheter were coordinated to adjust the abnormal T-tube and enter the hepatic bile duct. The 8.5F Cook external biliary drainage tube was introduced through the guide wire and placed into the intrahepatic bile duct for biliary negative pressure external drainage. Summarize and evaluate the therapeutic effect.

Postoperatively, the negative pressure drainage tube was unblocked in four patients, the bile leakage gradually stopped, and the intra-abdominal infection was controlled. One month after the operation, the radiographic examination showed that the drainage tube was in normal position, and no contrast agent spilled into the abdominal cavity. Two months after the operation, the T-tube and biliary drainage tube were removed, and the patients had no any discomfort. Followed up for1 year, the patient's condition did not recur.

The secondary placement of biliary drainage tube through T-tube under the guidance of DSA is a safe and effective method for the treatment of postoperative bile leakage after hepatobiliary surgery, which can avoid the recurrence of surgical operations and relieve the pain of patients.