Laparoscopic common bile duct exploration for choledocholithiasis (primary repair vs T-tube drainage)

• Published in: The Egyptian journal of surgery : official organ of the Egyptian Society of Surgeons = Majallat al-jirāhah al-Misrīyah 2020-04, Vol.39 (2), p.317-324
• Main Authors: Hasabelnabi, Mahmoud, El-Khateeb, Abdelmoniem, Makhlouf, Gamal, Aboulhassen, Ahmed, Fadel, Bashir, Abdel-Tawab, Mohamed
• Format: Article
• Language: English
• Subjects: Laparoscopy; Medical research; Physicians; Surgery
• ISSN: 1110-1121; 1687-7624
• DOI: 10.4103/ejs.ejs_208_19

Background Laparoscopic common bile duct exploration (LCBDE) offers good clinical outcomes in dealing with common bile duct stones. Surgeons experienced in laparoscopy can perform this procedure securely and efficiently. The goal of this study was to assess the security and possibility of primary repair as a substitute to usual T-tube drainage after LCBDE. Patients and methods This was a prospective study that included 40 successive patients who were subjected to LCBDE for common bile duct stones. After LCBDE, the choledochotomy was repaired either by primary repair (group A) in 20 patients or with T-tube insertion (group B) in 20 patients. The preoperative data, intraoperative details, and postoperative results of the two groups were assessed and evaluated with a mean follow-up of 12 months. Results The mean operation period was considerably lesser in group A than group B (101.1±27.7 min for group A vs 140.3±26 min for group B; P=0.000). Moreover, the hospital stay was considerably shorter in group A than in group B (2.8 days for group A vs 6.1 days for group B; P=0.017). Postoperative bile leakage occurred in two cases in each group. Conclusion Primary repair of choledochotomy is a secure alternate to usual T-tube insertion after LCBDE.