Primary Closure Versus Biliary Drainage After Laparoscopic Choledocotomy

Audouy, Cyril; Thereaux, Jéremie; Kansou, Gaby; Leroux, Geoffroy; Badic, Bogdan; Bail, Jean Pierre

doi:10.1097/sle.0000000000000242

Cited by 5 publications

(3 citation statements)

References 21 publications

(17 reference statements)

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“…The same result was reported in two recent studies [ 9 , 25 ]. In contrast, our result was inconsistent with some studies [ 4 , 13 , 14 , 17 , 48 ] that revealed that hospital stay was statistically significantly lower in the PDC group when compared with the TTD group. Moreover, a recent systematic review [ 11 ] and a comparative study [ 3 ] showed that hospital stay was statistically significantly longer in the TTD than in the PDC and ABS, but the two latter were no statistical difference.…”

Section: Discussioncontrasting

confidence: 99%

“…In contrast, a recent systemic review [ 11 ] showed that the operative time was statistically significantly longer in the TTD group versus the PDC group and ABS group. Also, two meta-analyses [ 14 , 17 ] and a comparative study [ 48 ] showed that the operative time was statistically significantly longer in the TTD group than in the PDC group.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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“…Traditional biliary drainage has a long duration of catheterization, which reduces the quality of life of patients and brings trouble to home care. Especially in patients with poor nutritional status, there is the possibility of biliary peritonitis and septic shock caused by the shedding of the drainage tube [ 3 ]. There are also some postoperative complications in primary closure, the most common of which is postoperative bile leakage.…”

Section: Introductionmentioning

confidence: 99%

Application of laparoscopic backtracking full-thickness continuous everting suture for non-AOSC choledocholithiasis

Yuan,

Zhang,

Kong

et al. 2023

BMC Surg

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Background Based on the current trend of increasing incidence of choledocholithiasis, it is of great significance to explore the closure method of the common bile duct during laparoscopic choledocholithotomy. Methods Backtracking full-thickness continuous everting suture was selected for primary closure of the common bile duct suture, while traditional T-tube drainage was selected for the control group. Propensity score matching (PSM) was used to reduce baseline differences between the two groups. Result The intraoperative blood loss, operation time, postoperative recovery speed, postoperative bleeding, postoperative pancreatitis, recurrence rate of bile duct stones, and hospitalization time in the primary closure group were all less than those in the T-tube drainage group. Conclusion Under certain conditions, backtracking full-thickness continuous everting suture could benefit patients with choledocholithiasis compared with traditional T-tube drainage.

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Can T-tube drainage be replaced by primary suture technique in laparoscopic common bile duct exploration? A meta-analysis of randomized controlled trials

Deng

Tian

et al. 2020

Langenbecks Arch Surg

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Primary Closure Versus Biliary Drainage After Laparoscopic Choledocotomy

Abstract: With shorter durations of surgery and hospital stay, equivalent postoperative morbi-mortality, and an absence of the specific morbidity due to bile drainage, PC may be considered a safe and feasible option for the laparoscopic management of CBD stones by choledocotomy.

Cited by 5 publications

References 21 publications

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

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

Application of laparoscopic backtracking full-thickness continuous everting suture for non-AOSC choledocholithiasis

Can T-tube drainage be replaced by primary suture technique in laparoscopic common bile duct exploration? A meta-analysis of randomized controlled trials

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