Common Bile Duct Stone Exploration: T-Tube or Biliary

Abstract

Introduction: Laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis is a popular option in many surgical institutes. Decompression of biliary system via T-tube post supraduodenal choledochotomy has been the traditional surgical practice. Primary closure of common bile duct (CBD) has been shown to reduce hospital stay but bears a risk of bile leak. We conducted a prospective randomized trial to compare complications and length of stay in patients undergoing biliary stent insertion versus T-tube drainage following LCBDE via choledochotomy. Methods and Procedures: The study involves 52 patients with choledocholithiasis who underwent LCBDE and decompression of the biliary system by either antegrade biliary stent or T-tube insertion. A 7 French biliary stent (9 "10 cm long) have been placed in 27 patients (group I), T-tube insertion have been used for 25 patients (group II). The length of hospital stay and complications were recorded. All transcystic explorations were excluded. Results: There were no significant differences between groups with respect to age, sex, comorbidities, number and size of CBD stones. Postoperative complications have been observed in 4 patients (16%) in the T-tube group (one patient needed reoperation for dislocation of T-tube),

Management of Common Bile Duct Stones: A Comprehensive Review

“…Grubnik, V. et al compared stent with T-tube drainage and reported shorter hospital stay and overall, less morbidity in the former. In addition, biliary stent reduces costs and patients report increase satisfaction [66].…”