Primary closure versus T-tube drainage for calculus obstructive jaundice

Abstract

Context Choledochotomy followed by T-tube has long been a standard surgical treatment for choledocholithiasis. Till now, it is the first choice in many hospitals where minimal invasive procedures are not feasible, although it has many complications. To avoid these complications, primary closure of the common bile duct (CBD) after exploration is performed. Aims This study aimed to assess the safety of primary closure of CBD, which would help for its implementation on a wider scale. Settings and design This randomized controlled trial was conducted in outpatient clinic of the Surgical Department, Faculty of Medicine, Sohag University Patients and methods A total of 50 patients were recruited from the outpatient clinic at Sohag University Hospital during the period from July 2019 to December 2020. They were randomly assigned into two groups: group A patients underwent CBD exploration with primary closure, and group B patients underwent CBD exploration with insertion of T-tube. Statistical analysis used Descriptive analysis (frequency, percentage, mean, and SD), χ2/Fisher’s exact test, and independent t test were applied. Results There was a significant difference between group A and group B cases regarding operative time and hospital stay. There was no significant difference between group A and group B cases regarding postoperative early and late complications. Conclusions Morbidity and length of hospital stay after primary closure of CBD after choledocholithotomy is significantly less compared with insertion of T-tube.