Comparison of the effect of primary suture and T tube drainage of laparoscopic common bile duct exploration in the treatment of patients with choledocholithiasis

Abstract

Objective To compare the effect of primary suture and T tube drainage of laparoscopic common bile duct exploration(LCBDE) in the treatment of patients with choledocholithiasis. Methods A total of 57 patients with calculus of extrahepatic bile duct were selected and they were randomly divided into observation group(n=25, treated by LCBDE) and control group(n=32, treated by T tube drainage). The operation time, postoperative recovery time of gastrointestinal tract, abdominal drainage time, postoperative hospital stay, hospitalization expenses and postoperative complications were recorded and compared between the two groups. Results All the patients were successfully completed surgery, and no patients had open surgery.The recovery time and postoperative hospital stay of the observation group were (1.7±0.5)d, (5.3±1.6)d, respectively, which were significantly shorter than (2.1±0.3)d, (9.2±1.9)d of the control group(t=11.73, 6.27, all P 0.05). There were 4 cases of postoperative bile leakage and 1 case of common bile duct residual stones in the observation group, and the incidence rate of complications was 20.00%.There were 2 cases of bile leakage, 3 cases of common bile duct residual stones and 2 cases of biliary peritonitis in the control group, and the incidence rate of complications was 21.87%.There was no statistically significant difference in the incidence rate of complications between the two groups (χ2=0.15, P>0.05). All the patients were followed up for 1 to 2 years, the recurrence rate of stones in the observation group was 12.00%, which was similar to 15.60% in the control group(χ2=0.36, P>0.05). Conclusion Primary suture of laparoscopic common bile duct exploration has the advantages such as less trauma, less pain, faster recovery and shorter hospital stay in the treatment of patients with choledocholithiasis, which is worthy of clinical application and popularization. Key words: Laparoscopy; Choledocholithiasis; Suture techniques; Drainage