Laparoscopic common bile duct exploration for choledocholithiasis

Abstract

Objective To assess the safety and efficacy of laparoscopic common bile duct (CBD) exploration for choledocholithiasis associated with cholelithiasis. Methods A retrospective study was conducted on all patients who underwent laparoscopic CBD exploration at the Affiliated Shantou Hospital of Sun Yat-sen University from January 2012 to December 2015. Their demographic, intraoperative, postoperative and follow-up data were analyzed. Results Of 376 patients who underwent laparoscopic CBD exploration, 339 patients had primary closure (the primary closure group) and 37 patients had T-tube drainage (the T-tube drainage group). The primary closure group was associated with a shorter operative time [(120.0±39.1) min vs. (165.8±49.9) min], hospitalization stay [(10.4±5.2) d vs. (14.8±6.0) d], postoperative intravenous infusion time [(4.5±2.8) d vs. (8.9±4.6) d], postoperative hospitalization stay [(5.1±3.2) d vs. (9.9±4.8) d], as well as a lower postoperative complication rate (3.2% vs. 16.2%) and a lower total hospitalization expenses [(20 334.1±8 013.2) ￥ vs. (23 762.0±6 776.4) ￥] when compared with the T-tube drainage group (P<0.05). T-tube drainage was frequently used in patients with a high total bilirubin, severe obstructive jaundice, biliary tract infection, and an obviously dilated common bile duct. Conclusions Laparoscopic CBD exploration was safe and feasible in treating choledocholithiasis associated with cholelithiasis. Laparoscopic CBD primary closure produced better results than T-tube drainage. Key words: Choledocholithiasis; Laparoscopic common bile duct exploration; Primary closure; T-tube drainage