title: Primary closure of the common bile duct in open laparotomy for common bile duct stones.
abstract: It is common these days to treat common bile duct (CBD) stones using endoscopic techniques. However, severe complications sometimes lead to death despite the great benefit of these techniques. If the patient has many and/or large stones, it can take considerable time for duct clearance, and this is associated with high costs. Therefore, we do not hesitate to choose surgical procedures when necessary. In this study, our aim was to evaluate the usefulness of primary closure of the CBD in open laparotomy for CBD stones. Thirty-four patients with CBD stones were operated on by open laparotomy; primary closure was done in 17 patients (group PC), and T-tube insertion was done in 17 (group TT). We compared the patients' medical records, clinical features, laboratory data, complications, and postoperative hospital admission days. There were no significant intergroup differences in patients' medical records, clinical features, or laboratory data, except for the number of CBD stones. There were no differences in complications. All complications were minor and needed no extra care. The number of postoperative hospital admission days showed a significant difference: 18.3 days in group PC and 31.5 in group TT. There are so many methods to treat CBD stones now that the selection of the procedure can be important for the patient's benefit. We prefer primary closure, to get better quality of life postoperatively and to avoid further operations and any severe complications.
authors.affiliation: Department of Surgery, Teikyo University School of Medicine Ichihara Hospital, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Yasuda
authors.forename: Souichirou
authors.initials: S
authors.lastname: Tsukamoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Koide
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yarita
authors.forename: Tohru
authors.initials: T
authors.lastname: Tezuka
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Takenoue
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kosugi
authors.forename: Maki
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Shiho
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Shuuji
authors.initials: S
authors.lastname: Naka
mesh_terms: D000368:Aged; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006760:Hospitalization; D006801:Humans; D007440:Intubation; D007813:Laparotomy; D008297:Male; D011183:Postoperative Complications; D011184:Postoperative Period; D011788:Quality of Life