Comparison of Primary Closure and T-tube Drainage following Laparoscopic CBD Exploration.
10.4174/jkss.2009.77.6.399
- Author:
Kyoung Tae NOH
1
;
Seog Ki MIN
;
Hyeon Kook LEE
Author Information
1. Department of Surgery, College of Medicine, Ewha Womans University School of Medicine, Seoul, Korea. leehk@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Common bile duct stones;
Laparoscopic common bile duct exploration;
Choledochotomy;
Primary closure
- MeSH:
Choledocholithiasis;
Common Bile Duct;
Constriction, Pathologic;
Drainage;
Follow-Up Studies;
Humans;
Incidence;
Length of Stay;
Postoperative Complications;
Stress, Psychological
- From:Journal of the Korean Surgical Society
2009;77(6):399-403
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Laparoscopic common bile duct exploration (LCBDE) has traditionally been accompanied by T-tube drainage. However, patients must carry it for several weeks and often suffer problems related to the T-tube. So, primary closure of CBD has been proposed as a safe and effective alternative to T-tube placement after laparoscopic choledochotomy. The aim of this study was to compare primary closure versus T-tube drainage after LCBDE. METHODS: Between January 2000 and December 2005, 63 patients suffering from choledocholithiasis underwent LCBDE successfully through choledochotomy. Those patients were devided into two groups; primary closure group (group P) and T-tube placement group (group T). Patients' clinical characeristics, postoperative outcome and follow up data were compared between the two groups. RESULTS: Of 63 patients, 30 (48.6%) had primary closure of the choledochotomy and 33 (52.4%) had T-tube drainage. Stone clearance rate was 100% in both groups. The mean operation time and the incidence of postoperative complications had no significant difference between the two groups. The mean postoperative hospital stay (8.8 vs. 16.4 days, P<0.001) was significantly shorter in the P group compared to the T group. Each group had one recurrent CBD stone. None of both groups showed symptoms or signs associated with CBD stricture during the follow up period. CONCLUSION: Primary closure of choledochotomy after LCBDE can prevent the disadvantages associated with T-tube and lead to a shorter hospital stay. Therefore, primary closure should be considered as a safe alternative method after LCBDE.
