After completing hemostasis in the surgical field, closed drains are placed in the right upper quadrant near the biliary anastomosis. If a percutaneous transhepatic stent has been removed, a drain should also be placed near the site of the stent entry site on the liver surface. We do not usually use stents for the anastomosis. Nasogastric tube decompression of the gastrointestinal tract is usually continued until return of bowel function. This is particularly important if the bile duct used for anastomosis is small. Nasogastric decompression prevents swelling of the Roux-en-Y limb and possible disruption of the anastomosis.
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