Closure of the Common Duct -Endonasobiliary Drainage Tubes vs. T Tube: A Comparative Study

Abstract

For the last century T tube drainage of the bile duct has remained standard practice following choledochlithotomy.

Laparoscopic Choledochotomy in a Solitary Common Duct Stone: A Prospective Study

“…It is a prospective study of 30 consecutive patients of solitary common bile duct stone showing a higher prevalence in females (60.0%) comparable to other studies [ 7 – 10 ], which could be due to female gender, hormones, and increased fat consumption with less physical work. The mean age was 49.2 ± 12.89 years with majority between 40 and 60 years of age similar to other studies [ 11 – 13 ]; their mean age varied from 42.25 to 47 years; but in some other studies [ 8 , 9 , 14 ] they had presented in older age (mean age 63 to 66.1 years). In our study the mean age of presentation was 56.0 years in males and 44.66 years in females.…”

“…Alkaline phosphatase was raised in 24 (80.0%) patients with a median of 253 U/L, higher than that in the study by Ricardi et al [ 7 ] where alkaline phosphatase was raised only in 56% of the patients with a mean value of 216 ± 10 U/L. Similar findings were noticed by Rogers et al [ 12 ] and Wani et al [ 13 ].…”

“…The most common location of the stone was distal CBD with as many as 26 (86.7%) patients with a mean diameter of 11.5 ± 2.43 mm (range 8 to 17 mm) comparable to a study by Chander et al [ 11 ] where the average diameter was 11.7 mm and majority (63%) of patients had the diameter between 8 mm and 15.4 mm and Topal et al [ 9 ] where the average diameter was 11.5 mm. However, Wani et al [ 13 ] and Khan et al [ 16 ] studies showed the mean common bile duct of 15 mm diameter. We chose to have solitary calculus as inclusion criteria as we were in the beginning of learning curve.…”

“…T-tube was used in all laparoscopic common bile duct explorations by Huang et al [ 22 ]. However in some studies [ 7 , 8 , 13 , 14 , 16 , 18 ] T-tube had been used in limited number of patients. They did primary closure of choledochotomy or used antegrade biliary stents.…”

“…They did primary closure of choledochotomy or used antegrade biliary stents. Wani et al [ 13 ] had shown successful use of endonasobiliary drainage. Shimizu et al [ 24 ] have described the use of the C tube through the cystic duct with a better outcome in terms of technical feasibility, lesser complication, early removal, and decreased hospital stay as compared to the use of T-tube.…”