title: Laparoscopic common bile duct exploration and antegrade biliary stenting: leaving behind the Kehr tube.
abstract: BACKGROUND
  single-stage laparoscopic surgery of cholelithiasis and associated common bile duct stones (CL-CBDS) has shown similar results when compared to laparoscopic cholecystectomy combined with ERCP. Classically, choledochorrhaphy has been protected by a T-tube drain to allow external bypass of bile flow. However, its removal is associated with a significant complication rate. Use of antegrade biliary stents avoids T-tube removal associated morbidity. The aim of this study is to compare the results of choledochorrhaphy plus T-tube drainage versus antegrade biliary stenting in our series of laparoscopic common bile duct explorations (LCBDE).
  
  
  METHODS
  between 2004 and 2011, 75 patients underwent a LCBDE. Choledochorrhaphy was performed followingKehr tube placements in 47 cases and transpapillary biliary stentingwas conducted in the remaining 28 patients.
  
  
  RESULTS
  postoperative hospital stay was shorter in the stent group (5 ± 10.26 days) than in the Kehr group (12 ± 10.6 days), with a statistically significant difference. There was a greater trend to grade B complications in the stent group (10.7 vs. 4.3 %) and to grade C complications in the Kehr group (6.4 vs. 3.6 %). Therewere 3 cases of residual common bile duct stones in the Kehr group (6.4 %) and none in the stent group.
  
  
  CONCLUSIONS
  antegrade biliary stenting following laparoscopic common bile duct exploration for CL-CBDS is an effective and safe technique that prevents T-tube related morbidity.
authors.forename: Darío
authors.initials: D
authors.lastname: Martínez-Baena
authors.forename: Pablo
authors.initials: P
authors.lastname: Parra-Membríves
authors.forename: Daniel
authors.initials: D
authors.lastname: Díaz-Gómez
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Lorente-Herce
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000295:instrumentation; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods; D012189:Retrospective Studies; D015607:Stents