Application value of percutaneous transhepatic cholangial drainage in laparoscopic common bile duct exploration with primary closure
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R657.4

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    Abstract:

    Objective: To evaluate the application value of percutaneous transhepatic cholangial drainage (PTCD) in laparoscopic common bile duct exploration (LCBDE) with primary closure. Methods: The clinical data of 65 patients with gallbladder stones and concomitant bile duct stones undergoing LCBDE and primary closure in the Third Division of Hepatopancreatobiliary Surgery of the Second Affiliated Hospital, Kunming Medical University from June 2015 to June 2016 were retrospectively analyzed. Of the patients, 33 cases received preoperative PTCD treatment and retention of the PTCD tube for postoperative drainage (PTCD group), and 32 cases did not receive PTCD treatment (non-PTCD group). The main clinical variables between the two groups of patients were compared. Results: Operation was successfully performed in all the 65 patients, without any open conversion. In PTCD group compared with non-PTCD group, the average operative time (119.5 min vs. 136.6 min), intraoperative blood loss (44.70 mL vs. 62.81 mL), time to first gas passage (9.52 h vs. 11.13 h), length of postoperative hospital stay (11.85 d vs. 13.53 d), and hospitalization cost (12 800 yuan vs. 14 400 yuan) were all significantly reduced (all P<0.05). The direct bilirubin levels in both group were decreased compared with their preoperative values, but the pre- and postoperative direct bilirubin levels showed no significant difference between the two groups (both P>0.05). There was no significant difference in incidence of postoperative complications between PTCD group and no-PTCD group (3.0% vs. 15.6%, P=0.087). Conclusion: In patients with gallbladder stones and concomitant bile duct stones undergoing LCBDE and primary closure, as long as the diameter of the bile duct is greater than 1.0 cm, even if there is no severe liver injury, PTCD placement is recommended, which may be helpful for liver function recovery, and reducing the length and cost of hospitalization.

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CHEN Zhangbin, CHEN Jianzhong, TENG Yishan. Application value of percutaneous transhepatic cholangial drainage in laparoscopic common bile duct exploration with primary closure[J]. Chin J Gen Surg,2018,27(2):156-162.
DOI:10.3978/j. issn.1005-6947.2018.02.004

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History
  • Received:August 14,2017
  • Revised:January 15,2018
  • Adopted:
  • Online: February 15,2018
  • Published: