Ten-year experience on common bile duct exploration without T-tube insertion.
10.14701/kjhbps.2013.17.2.70
- Author:
Whanbong LEE
1
;
Jungnam KWON
Author Information
1. Department of Surgery, Sanbon Hospital, Wonkwang University, Gunpo, Korea. whanbong@hotmail.com
- Publication Type:Original Article
- Keywords:
T-tube;
Choledochotomy
- MeSH:
Bile;
Cholangiography;
Cholecystectomy;
Common Bile Duct;
Follow-Up Studies;
Humans;
Jaundice, Obstructive;
Laparoscopy;
Pancreatitis;
Peritonitis;
Sphincterotomy, Endoscopic
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2013;17(2):70-74
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUNDS/AIMS: Common bile duct (CBD) exploration has been a procedure necessary to remove stones which are not removable by endoscopic sphincterotomy (EST). T-tube was installed mainly in the concern of bile leakage after procedure. But T-tube itself can only cause bile peritonitis and thus, prolonged discomfort and care after operation. In addition, in the era of laparoscopy, T-tube insertion adds much operation time and is technically difficult for installation during the procedure. METHODS: Our case of open cholecystectomy and primary closure of CBD not leaving T-tube (n=28, group I) with reports dating from July 1998 to June 2007 is presented here to see whether primary closure without T-tube is safe as compared with T-tube inserted cases performed at the same center (n=15, group II). Operative cholangiography, CT scan, ultrasound and biochemical data were followed up for both groups and surveyed on operative complications as well to determine the outcomes. RESULTS: Bile leakage in 1, recurrent stone in 2 and obstructive jaundice in 1 were all considered during the follow up period among 28 group I patients (n=6), when compared to T-tube inserted group II patients with 2 bile peritonitis, 1 residual stones and 1 pancreatitis (n=4), showing no meaningful differences (p=0.07). CONCLUSIONS: CBD exploration and direct primary closure not leaving T-tube is an acceptable operational option as recently tried in many choledochotomies.
