title: Laparoscopic primary closure of common bile duct combined with percutaneous cholangiographic drainage for treating choledocholithiasis.
abstract: The aim of this study was to compare the efficacy and safety of laparoscopic primary closure of the common bile duct (CBD) combined with percutaneous transhepatic cholangiographic drainage (PTCD) and laparoscopic choledocholithotomy with T-tube placement for the treatment of CBD stones. Between January 1991 and July 2002, 50 patients with choledocholithiasis and a CBD diameter larger than or equal to 1 cm underwent laparoscopic CBD explorations. The study group consisted of 10 patients undergoing laparoscopic primary closure of the CBD combined with PTCD. The control group consisted of 40 patients undergoing laparoscopic choledocholithotomy with T-tube placement. Parameters were compared statistically. The study group showed higher female/male ratio (6/4 vs. 8/32, P = 0.02), less stone numbers (1.90 +/- 0.88 vs. 3.40 +/- 1.65, P = 0.0078), shorter operation time (138 +/- 37 minutes vs. 191 +/- 75 minutes, P = 0.014), and shorter postoperative stays (7 +/- 3 days vs. 10 +/- 3 days, P = 0.0013). It seems that laparoscopic primary closure of the CBD combined with PTCD can shorten the operation time and postoperative stays as compared with laparoscopic choledocholithotomy with T-tube placement for the treatment of CBD stones.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taiwan, Republic of China.
authors.forename: Shing-Moo
authors.initials: SM
authors.lastname: Huang
authors.forename: Chung-Chin
authors.initials: CC
authors.lastname: Yao
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Cheng
authors.forename: Ling-Yun
authors.initials: LY
authors.lastname: Chen
authors.forename: Huichin
authors.initials: H
authors.lastname: Pan
authors.forename: Kuang-Ming
authors.initials: KM
authors.lastname: Hsiao
authors.forename: Mei-Due
authors.initials: MD
authors.lastname: Yang
authors.forename: Chew-wun
authors.initials: CW
authors.lastname: Wu
authors.forename: Wing-yiu
authors.initials: WY
authors.lastname: Lui
authors.forename: Te-jen
authors.initials: TJ
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002758:Cholangiography; D042883:Choledocholithiasis / Q000175:diagnosis / Q000601:surgery*; D002768:Choledochostomy; D015331:Cohort Studies; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques; D016896:Treatment Outcome