Primary Closure of the Common Duct

Rienhoff, William F.

doi:10.1097/00000658-196002000-00016

Cited by 18 publications

(20 citation statements)

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“…It is true that the T-tube drainage has been proven to be a safe and effective method for post-operative biliary decompression, but it is not exempt from complications, which are present in up to 10% of patients [3]. The T-tube acts as a foreign body around which bile pigments and bile salts may precipitate [31], and the incidence of recurring stones would be greater in patients with choledochotomy followed by T-tube drainage. And significant bile leak following T-tube removal is said to occur in 1.2%-30% of cases [32].…”

Section: Discussionmentioning

confidence: 99%

Primary closure versus T-tube drainage after common bile duct exploration for choledocholithiasis

Zhu

Tao

Zhou

et al. 2010

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 99%

Primary closure versus T-tube drainage after common bile duct exploration for choledocholithiasis

Zhu

Tao

Zhou

et al. 2010

Langenbecks Arch Surg

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“…We observed that the LTCBDE group showed significantly lower biliary morbidity than the LCCBDE group. A T-tube acts as a foreign body around which bile pigments and salts can precipitate [ 16 ]. Therefore, in LTCBDE, the recurrence of stone formation was lower because it eliminated the subsequent need for a T-tube.…”

Section: Discussionmentioning

confidence: 99%

“…Our research and that of several groups has reported that LTCBDE is certainly the least invasive, safest, and most efficient option, with low morbidity rates [ 13 – 15 ]. LTCBDE avoids choledochotomy and eliminates the subsequent requirement of a T-tube; thus avoiding T-tube prolapse or displacement, CBD stricture, electrolyte imbalance, acid-base balance disorders, and complications caused by bile drainage and invasive treatments [ 16 ]. Additionally, the treatment facilitates rapid recovery.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Transcystic Common Bile Duct Exploration: Advantages over Laparoscopic Choledochotomy

Feng¹,

Huang²,

Wang³

et al. 2016

PLoS ONE

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PurposeThe ideal treatment for choledocholithiasis should be simple, readily available, reliable, minimally invasive and cost-effective for patients. We performed this study to compare the benefits and drawbacks of different laparoscopic approaches (transcystic and choledochotomy) for removal of common bile duct stones.MethodsA systematic search was implemented for relevant literature using Cochrane, PubMed, Ovid Medline, EMBASE and Wanfang databases. Both the fixed-effects and random-effects models were used to calculate the odds ratio (OR) or the mean difference (MD) with 95% confidence interval (CI) for this study.ResultsThe meta-analysis included 18 trials involving 2,782 patients. There were no statistically significant differences between laparoscopic choledochotomy for common bile duct exploration (LCCBDE) (n = 1,222) and laparoscopic transcystic common bile duct exploration (LTCBDE) (n = 1,560) regarding stone clearance (OR 0.73, 95% CI 0.50–1.07; P = 0.11), conversion to other procedures (OR 0.62, 95% CI 0.21–1.79; P = 0.38), total morbidity (OR 1.65, 95% CI 0.92–2.96; P = 0.09), operative time (MD 12.34, 95% CI −0.10–24.78; P = 0.05), and blood loss (MD 1.95, 95% CI −9.56–13.46; P = 0.74). However, the LTCBDE group showed significantly better results for biliary morbidity (OR 4.25, 95% CI 2.30–7.85; P<0.001), hospital stay (MD 2.52, 95% CI 1.29–3.75; P<0.001), and hospital expenses (MD 0.30, 95% CI 0.23–0.37; P<0.001) than the LCCBDE group.ConclusionsLTCBDE is safer than LCCBDE, and is the ideal treatment for common bile duct stones.

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“…Biliary ascariasis [Fig. 6,7,8]; patients with no history of previous biliary surgery; patients with no evidence of papillary stenosis or retained stones (confirmed by palpation, saline irrigation and bougie incorporation); no evidence of acute pancreatitis and acute cholangitis were other criteria's to select the cases.177 (39%) cases had worm (1-4 in no) in the CBD. These are closed primarily.…”

Section: Introductionmentioning

confidence: 99%

T-Tube Applicationafter CBD Explorationis Not Always Necessary: A Study

Choudhury¹

2014

jemds

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BACKGROUND: Routine application of supraduodenal T-tube after choledochotomy is absolutely not necessary. T-tube application gives various complications with high morbidity and reported cases of mortality and increases hospital stay. Materials and methods-Primary closure of CBD following choledochotomy is studied on 457 cases of choledocholithiasis and biliary ascariasis with CBD diameter less than 2.5cms. Most of the cases had 1-3 stone that didn't require much manipulation during extraction. The choledochotomy wound were closed by single layer of interrupted 3-0 vicryl suture. RESULT: Post-operative period was uneventful except transient jaundice which subsided within few days in some cases. Most of the patients were discharged after 2-3 days. Conclusions-Primary closure of choledochotomy is routinely advocated due to many fold advantages and T-tube is considered to be applied in a very special situation.

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Primary Closure of the Common Duct

Cited by 18 publications

References 0 publications

Primary closure versus T-tube drainage after common bile duct exploration for choledocholithiasis

Primary closure versus T-tube drainage after common bile duct exploration for choledocholithiasis

Laparoscopic Transcystic Common Bile Duct Exploration: Advantages over Laparoscopic Choledochotomy

T-Tube Applicationafter CBD Explorationis Not Always Necessary: A Study

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