title: Choledochorraphy (primary repair) versus t-tube drainage after open choledochotomy.
abstract: BACKGROUND
  T-tube drainage used to be standard practice after surgical choledochotomy, but there is now a tendency in some canters to close the common bile duct primarily. This study was designed to compare the clinical results of primary closure with T-tube drainage after open choledocotomy and assess the safety of primary closure for future application.
  
  
  METHODS
  This study was conducted at surgical Unit-3, ward 26 Jinnah Postgraduate Medical Centre Karachi, from January 2007 to January 2008. Forty patients were included in this study out of which 20 underwent primary closure and 20 T-tube placements. It was Quasi-experimental, non-probability, purposive sampling. Main outcome measures were operating time, duration of hospital stay, and postoperative complications. SPSS-10 was used for data analysis.
  
  
  RESULTS
  The age of patients in the study ranged from 29-83 years. There were 3 male while 37 female patients. Group-1 consisted of 20 patients underwent primary closure after choledocotomy, while Group-2 also consisted of 20 patients underwent T-tube drainage after duct exploration. Mean hospital stay in Group-1 patients was 7.63 days while in group 2 it was 13.6 days. Overall complication rate in group 1 was 15%, biliary leakage in 1 (5%), jaundice in 1 (5%), wound infection in 1 (5%). No re-exploration was required in Group-1. In Group-2 overall complication rate was 30%, biliary leakage in 2 (2%), jaundice in 1 (5%), dislodgement of T-tube in 1 (5%), wound infection in 1 (5%), and sepsis in 1 (5%) patients. Re-exploration was done in one patient.
  
  
  CONCLUSIONS
  Primary closure of Common Bile Duct (CBD) is a safe and cost-effective alternative procedure to routine T-tube drainage after open choledocotomy.
authors.affiliation: Jinnah Postgraduate Medical Centre, Karachi, Pakistan. nadia_saeeddr@hotmail.com
authors.forename: Nadia
authors.initials: N
authors.lastname: Saeed
authors.forename: Muhammad Tauqeer
authors.initials: MT
authors.lastname: Nasir
authors.forename: Muhammad Iqbal
authors.initials: MI
authors.lastname: Khan
authors.forename: Ghulam Asghar
authors.initials: GA
authors.lastname: Channa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042883:Choledocholithiasis / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications