Primary closure versus T-tube drainage following laparoscopic common bile duct exploration in acute cholangitis cases

Abstract

Objective To compare the clinical efficacy of primary closure versus T-tube drainage after laparoscopic common bile duct exploration in acute cholangitis cases. Methods The clinical data of 100 patients with acute cholangitis undergoing laparoscopic common bile duct exploration from January 2012 to December 2014 were reviewed. 54patients received primary closure of the common bile duct and 46 patients were subjected to T-tube drainage after choledochotomy. Results One hundred patients underwent the surgery successfully. Compared with the T-tube group, the operation time(96.72 min vs 123.00 min, P=0.001), intraoperative blood loss(27.13 ml vs 38.48 ml, P=0.009), postoperative gastrointestinal function recovery time(1.57 d vs 2.33 d, P=0.003) and postoperative hospital stay(6.19 d vs 9.20 d, P=0.000) were significantly less in the primary closure group. There were no statistical differences in the incidence of postoperative drainage(309.22 ml vs 212.46 ml, P=0.070), drainage time(3.96 d vs 4.02 d, P=0.875), incidence of bile leakage(9.3% vs 0, P=0.060) and postoperative bleeding rate(5.1% vs 2.2%, P=0.622) between these two groups. Conclusion Laparoscopic common bile duct exploration with primary closure of the common bile duct is an effective and safe procedure in acute cholangitis cases compared with T-tube drainage. Key words: Cholangitis, acute; Laparoscopic common bile duct exploration; Suture techniques; T-tube drainage; Feasibility studies