Journal List > J Korean Surg Soc > v.77(6) > 1011042

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Noh, Min, and Lee: Comparison of Primary Closure and T-tube Drainage following Laparoscopic CBD Exploration
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2009; 77(6): 399-403.

Published online: 4 December 2009

DOI: https://doi.org/10.4174/jkss.2009.77.6.399

Comparison of Primary Closure and T-tube Drainage following Laparoscopic CBD Exploration

Kyoung Tae Noh, M.D., Seog Ki Min, M.D., Hyeon Kook Lee, M.D.

Department of Surgery, College of Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author (leehk@ewha.ac.kr)

Received 21 July 2009       Accepted 14 September 2009

Copyright © 2009 The Korean Surgical Society

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.

Keywords: Common bile duct stones, Laparoscopic common bile duct exploration, Choledochotomy, Primary closure

Figures and Tables

Table 1
Characteristics of the patients
jkss-77-399-i001

*ASA score = American Society of Anesthesiology score.

Table 2
Comparison of LCBDE* between T group and P group
jkss-77-399-i002

*LCBDE = laparoscopic common bile duct exploration.

Table 3
Follow up of patients with LCBDE*
jkss-77-399-i003

*LCBDE = laparoscopic common bile duct exploration.

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