Descending intraoperative nasobiliary drainage plus primary closure of the commom bile duct after laparascopic CBD stone clearance

Abstract

Objective To evaluate intraoperative dascending nasobiliary drainage tube placement and primary closure of the common bile duct (CBD) in laparoscopic common bile duct exploration and lithotomy. Methods 80 cases of gallbladder stones with common bile duct stones were randomly divided into study group and control group, undergoing respectively laparoscopic common bile duct exploration and primary CBD closure with the help of descending nasobiliary drainage tube, and laparoscopic common bile duct exploration, T tube drainage. Results There was no significant difference between the two groups in preoperative parameters nor in operation length, blood loss and conversion rate. The control group was significantly earlier than the control group in T tube removal (t=4.168, P<0.001). In control group, there were 6 cases of bile leakage, while in study group, there was no bile leakage. The hospital stays was shorter (t=-2.778, P=0.007), and the cost was lower in study group than that in control group. Conclusions Laparoscopic common bile duct stone clearance and primary closure using a descending nasal-biliary drainage tube placed intraoperatively before CBD closure is a feasible, safe, effective method to treat common bile duct stones. Key words: Cholelithiasis; Laparoscopes; Exploration of common bile duct; Drainage, nasobiliary