Is primary closure a feasible and acceptable option in the era of t-tube-free common bile duct exploration for choledocholithiasis?

• Published in: The Egyptian journal of surgery : official organ of the Egyptian Society of Surgeons = Majallat al-jirāhah al-Misrīyah 2016-07, Vol.35 (3), p.254-261
• Main Authors: El Hanafy, Ehab, Atif, Ehab, El Nakeeb, Ayman, Abdel-Raouf, Ahmed, Shehta, Ahmed, Abdel-Aziz, Mohamed
• Format: Article
• Language: English
• Subjects: Care and treatment; Gallstones; Health aspects; Medical tubing; Quality of life
• ISSN: 1110-1121; 1687-7624
• DOI: 10.4103/1110-1121.189415

Introduction Common bile duct exploration (CBDE) has the advantage of managing cholecystocholedocholithiasis with single-stage procedure. There is still a debate about the benefits and drawbacks after T-tube usage. The aim of this study was to evaluate the value of primary common bile duct (CBD) closure and routine T-tube usage after CBDE. Patients and methods A total of 220 patients underwent CBDE by means of choledochotomy for common bile duct stones. Patients were divided into two groups. Group A included 63 patients who were managed with primary closure of the CBD, and group B included 157 patients who were managed using T-tube after assumed CBD clearance. Demographics, preoperative radiology, intraoperative findings, and postoperative complications were collected and analyzed between the two groups. Results Among the study patients, 138 patients (63%) underwent laparoscopic common bile duct exploration: 36 patients (57%) in group A and 102 patients (65%) in group B. Wound infection and abdominal collections were significantly more obvious in group B patients (P