[Primary duct closure versus T-tube drainage following laparoscopic choledochotomy].
OBJECTIVE
To evaluate the effects of primary duct closure and T-tube drainage in laparoscopy choledochotomy to treat the common bile duct stones.


METHODS
The enrollment of the patients was in accordance with 6 criteria. 55 patients with cholecystolithiasis and secondary common bile duct stones from January 2000 to February 2003 were treated with laparoscopic choledochotomy. The patients were randomly divided into two groups: primary duct closure group and T-tube drainage group. Their all data were recorded and studied prospectively,and patients were followed up after discharge.


RESULTS
There were 27 patients and 28 patients in primary duct closure group and T-tube drainage group respectively. The operation time and the results of following up between the two groups had no significant difference. Compared with T-tube drainage group, primary duct closure group had less the total quantity of postoperative transfusion and hospital costs, shorter postoperative hospital stay. The incidence of postoperative complications in primary duct closure group was 11.1% (3/27), and all of them were biliary complications. The incidence of postoperative complications in T-tube drainage group was 28.6% (8/28), and seven of them were biliary complications. The incidence of severe complications that needed reoperations was 10.7% (93/28), and all of them were caused by T-tubes. There was no mortality in two groups.


CONCLUSIONS
The primary duct closure in laparoscopic choledochotomy can avoid the deficiency of T-tube drainage, and it is feasible and safe and lower complications in treating the common bile duct stones, so we advocate it in appropriate cases.
Zhang
Lei-da
LD
Department of Hepatobiliary Surgery of Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Bie
Ping
P
Chen
Ping
P
Wang
Shu-guang
SG
Ma
Kuan-sheng
KS
Dong
Jia-hong
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D042883:Choledocholithiasis / Q000601:surgery*; D002768:Choledochostomy / Q000379:methods*; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques; D016896:Treatment Outcome