Efficacy analysis of primary closure of common bile duct after laparoscopic common bile duct exploration
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R657.4

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    Abstract:

    Objective: To evaluate the safety and feasibility of laparoscopic common bile duct exploration (LCBDE) with primary closure of the common bile duct. Methods: The clinical data of patients undergoing LCBDE in Foshan Hospital affiliated to Southern Medical University from June 2013 to September 2016 were retrospectively analyzed. Of the patients, 62 cases received intraoperative primary closure of the common bile duct (study group), and 38 cases had T-tube drainage (control group). The main clinical variables between the two groups of patients were compared. Results: There were no significant differences in gender, BMI and diameter of the common bile duct between the two groups of patients (all P>0.05). In study group compared with control group, the mean operative time was significantly prolonged (113.92 min vs. 95.92 min, P=0.032), but the residual stone rate was significantly reduced (0 vs. 6.0%, P=0.002), while the length of postoperative hospital stay showed no significant difference (4.00 d vs. 5.11 d, P=0.088). The overall incidence of postoperative complications showed no significant difference between the two groups (8.1 vs. 5.3%, P=0.701), and grade A and B biliary fistula occurred in one and two cases respectively in study group, which were all resolved by conservative treatment. No open conversion was required and on death occurred in either of the groups. Follow-up was performed in both groups of patients for at least 12 months, and no stone recurrence or symptomatic stricture of the common bile duct was noted. Conclusion: In selected patients, LCBDE with primary closure of the common bile duct has favorable short- and long-term efficacy, and can improve the patients’ quality of life and avoid the complications associated with use of T-tube.

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WEN Shunqian, XIE Xueyi, WU Qing, YANG Shanglin, CHEN Junpeng, LIAO Guanqun. Efficacy analysis of primary closure of common bile duct after laparoscopic common bile duct exploration[J]. Chin J Gen Surg,2018,27(2):163-168.
DOI:10.3978/j. issn.1005-6947.2018.02.005

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History
  • Received:October 15,2017
  • Revised:January 19,2018
  • Adopted:
  • Online: February 15,2018
  • Published: