Results of retrograde transhepatic biliary drainage after a common bile duct exploration for choledocholithiasis.
OBJECTIVE
The purpose of this study is to assess the benefits of retrograde transhepatic biliary drainage (RTBD) and a primary closure after a common bile duct (CBD) exploration for patients with choledocholithiasis.


METHODS
We analyzed 143 patients with choledocholithiasis who had been managed by RTBD after undergoing a CBD exploration retrospectively over a 12-year period. The main outcome criteria were frequency of occurrence of post-operative complications which needed a relaparotomy and the clinical long-term results. In addition, the radiographic diameter changes of the CBD at the site of the primary closure and liver function tests after RTBD were also evaluated.


RESULTS
The frequency of bile peritonitis in the patients undergoing the RTBD procedure was only 0.7% (1 out of 143 cases). Cholangiography via the RTBD tube revealed no severe stenosis at the site of primary closure. Liver function returned to normal on day 3 after RTBD (p<0.05). Recurrence of common bile duct stones developed in 2 patients in this series during the follow-up (1-12 years).


CONCLUSIONS
RTBD and a primary closure of the CBD after CBD exploration appears to be a clinically safe and effective method for such patients with choledocholithiasis who had undergone a complete stone removal intra-operatively.
Kusano
T
T
First Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Isa
T
T
Shimoji
H
H
Miyazato
H
H
Muto
Y
Y
Furukawa
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D002758:Cholangiography; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies