title: Primary Closure Following Laparoscopic Common Bile Duct Reexploration for the Patients Who Underwent Prior Biliary Operation.
abstract: To assess feasibility of primary closure following laparoscopic common bile duct reexploration for the patients who underwent prior biliary operation, we retrospectively studied 50 patients with recurrent or residual common bile duct (CBD) stones who underwent laparoscopic biliary reoperation between June 2008 and June 2013. Endoscopic sphincterotomy (EST) was treated for all these patients and validated failed. They were divided into two groups. Primary closure following laparoscopic common bile duct exploration (LCBDE) was performed in 25 cases (group A); LCBDE plus T-tube drainage was performed in others (group B). The items of operation were compared. The duration of the operation in group A was shorter than that in group B (141 ± 85 vs 158 ± 71 min,p< 0.05), as was postoperative hospital stay (16 ± 2.3 vs 23 ± 2.3 h,p< 0.05) and the times of postoperative gastrointestinal function recovery (16 ± 2.3 vs 23 ± 2.3 h,p< 0.05). Just one duodenum was damaged in group B. Postoperative clinically significant bile leakage occurred in two patients in group A and one case in group B. The median follow-up was 18 months. No postoperative pancreatitis, postoperative bleeding, bile peritonitis after T-tube removal, stricture of bile duct, and death occurred in the two groups. Just two cases in group B were verified residual stones after 1 month. Primary closure following laparoscopic common bile duct reexploration for the patients who underwent prior biliary operation appears to be a minimally invasive, safe, feasible, and effective procedure when done by expert laparoscopic surgeons.
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Soochow, Jiangsu 215004 China.|Department of General Surgery, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu 214200 China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu 214200 China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhan
authors.affiliation: Department of General Surgery, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu 214200 China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu 214200 China.
authors.forename: Chao
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of General Surgery, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu 214200 China.
authors.forename: Miao
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu 214200 China.
authors.forename: Xiaotian
authors.initials: X
authors.lastname: Yu
authors.affiliation: Central Laboratory, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu China.
authors.forename: Tieliang
authors.initials: T
authors.lastname: Ma
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Soochow, Jiangsu 215004 China.
authors.forename: Haorong
authors.initials: H
authors.lastname: Wu
keywords: CBD stones; Laparoscopic common bile duct reexploration; Primary closure; Prior biliary operation