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Backgrounds:Postoperative percutaneous choledochoscopy via T tube sinus tract is a common modality for treating retained intrahepatic stones in China.We report a rare complication of postoperative choledochoscopy for treating retained hepatolithiasis:T tube sinus tract duodenal fistula.Methods:From January 2003 to December 2011,2583 postoperative percutaneous choledochoscopy sessions were performed in 847 patients with T tubes in situ.Intrahepatic duct stones with or without common bile duct(CBD)stones were detected in 526 patients.Eight of the 526 patients with intrahepatic stones developed a T tube sinus tract duodenal fistula that was diagnosed by cholangiography and choledochoscopy.The causes,manifestations,diagnosis,treatment and methods of prevention were retrospectively analyzed.Results:The incidence of T tube sinus tract duodenal fistula in patients with retained intrahepatic stones being treated by postoperative choledochoscopy is 1.52%(8/526)in this series.After a mean duration of 2.2 weeks,occlusions of the distal channel of T Tube were developed in five patients and resulted in failure to get access to CBD for further stones extraction choledochoscopically.The fistula accounted for 12.5%(5/40)of all causes of residual stones after being treated by postoperative choledochoscopy in this series.All cutaneous fistulas healed in a mean time of 4.9 days after removal of the T tubes.Two patients underwent reoperations for recurrent cholangitis.Conclusions:Long time placement of T tube in situ is probably the main cause of the T tube sinus tract duodenal fistula.Placement of T tube in correct way and finishing the whole choledochoscopic stones extraction procedure in short time are the key points to prevent T tube sinus tract duodenal fistula formation.