Choledochotomy: primary closure versus T-tube. A prospective trial.
From January 1986 until December 1988 twenty two patients entered a prospective trial comparing primary closure versus T-tube drainage after exploratory choledochotomy for lithiasis, giving 11 primary closures (P) and 11 on T-tube (T). Both groups were well matched for age and risk factors. Preoperative values of alkaline phosphatase on day 2 and 7 were significantly lower in case of primary closure (p less than .025). In case of primary closure there was 1 bile leakage without peritonitis. In 9 T-tube biles additional micro-organisms appeared without clinical importance. In each group 1 infectious complication occurred. Post-operative hospital stay was 12 days (P) versus 14 (T) (p less than .05). There was 1 residual lithiasis (P), without detrimental effect on the healing of the primary closure. Endoscopic sphincterotomy and stone extraction was performed. Within the given exclusion criteria closing a choledochotomy primarily is a safe and attractive procedure.
De Roover
D
D
Dienst Algemene Heelkunde, AZ Middelheim, Antwerpen.
Vanderveken
M
M
Gerard
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D003135:Common Bile Duct / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013537:Sutures
D000469:Alkaline Phosphatase