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

Hanafy, Ehab El; Atif, Ehab; Nakeeb, Ayman El; Abdel-Raouf, Ahmed; Shehta, Ahmed; Abdelaziz, Mohamed

doi:10.4103/1110-1121.189415

Cited by 1 publication

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“…It was statistically significantly shorter in the ABS group than in the TTD group and the PDC group. Our result was inconsistent with some studies [ 4 , 10 , 47 , 49 ] that showed that the PDC was superior to the TTD regarding the drain carried time. To our knowledge, no published studies compared the ABS and the PDC regarding the drain carried time.…”

Section: Discussioncontrasting

confidence: 99%

“…Our results revealed no procedure-related mortality among the three groups, and this was consistent with several published studies [ 4 , 14 , 17 , 25 , 46 , 47 ]. In the contrast, a recent systemic review with meta-analysis [ 11 ] revealed a slightly lower rate of postoperative mortality in the PDC group and ABS group versus the TTD group with no significant difference.…”

Section: Discussionsupporting

confidence: 93%

“…The same results were reported by Xiao et al [ 25 ]. In contrast, El Hanafy et al [ 47 ] reported that there was no statistically significant reduction in the serum bilirubin level on the first or third postoperative days between the TTD group and PDC group.…”

Section: Discussionmentioning

confidence: 93%

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Comparative study of three common bile duct closure techniques after choledocholithotomy: safety and efficacy

Omar

Redwan

Alansary

2022

Langenbecks Arch Surg

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Purpose T-tube drainage, primary closure, and biliary stenting are the common bile duct closure methods. There is great debate on the optimal duct closure technique after common bile duct exploration. This study aimed to assess the safety and efficacy of the three commonest common bile duct closure methods after common bile duct exploration for common bile duct stone for future generalization. Methods In this analysis, 211 patients with common bile duct stone underwent common bile duct exploration from January 2016 to December 2020. The patients were divided according to common bile duct closure techniques into three groups, including the T-tube drainage group (63 patients), primary duct closure group (61 patients), and antegrade biliary stenting group (87 patients). Results The incidence of overall biliary complications and bile leak were statistically significantly lower in the biliary stenting group than in the other two groups. Also, hospital stays, drain carried time, return to normal activity, re-intervention, and re-admission rates were statistically significantly lower in the biliary stenting group than in the other two groups. There were no statistically significant differences regarding operative and choledochotomy time, retained and recurrent stone, stricture, biliary peritonitis, cholangitis, and the cost among the three groups. Conclusions We state that the biliary stenting procedure should be the preferred first option for common bile duct closure after common bile duct exploration when compared with T-tube drainage and primary duct closure. Trial registration ClinicalTrials.gov PRS (Approval No. NCT04264299).

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