Laparoscopic management of common bile duct stones: Stent Vs T-tube drainage

Abstract

Background: The management of concomitant gallbladder and common bile duct (CBD) stones is controversial. We study the outcomes of laparoscopic management of common bile duct (CBD) stones with stent placement and primary closure against T-tube drainage. Patients and Methods: A series of 31 patients (17 females and 14 males) aged between 30 and 55 years, who underwent biliary decompression after laparoscopic CBD exploration to treat choledocholithiasis, was studied retrospectively from May 2009 to December 2015. The results in patients with stent (11) were compared with those who had T-tube drainage (20). Results: Stent placement and T-tube drainage was achieved in all cases by choledochotomy after adequate clearance of CBD. No mortality was reported in our series. Patients with T-tube drainage had more morbidity and complications compared to stented patients. Stents were successfully removed in all cases in the postoperative follow up by endoscopy. Conclusions: Laparoscopic CBD stenting is a safe method in the treatment of selected patients of CBD stones who need biliary decompression. Because of lower morbidity and shorter hospital stay compared with T-tube drainage, it should be considered as the first approach whenever biliary decompression is needed after LCBDE.