Surgical drainage versus repair in the treatment of distal common bile duct injury

Abstract

Objective To compare the efficacy of surgical drainage versus repair in the treatment of iatrogenic injury of the distal common bile duct detected during operation, and to evaluate the effect of gastrobiliary duct drainage. Methods Patients with iatrogenic choledochal injury were divided into two groups: the drainage group (n=17) and the repair group (n=7). Data on the amounts of postoperative biliary and abdominal cavity drainage, gastrointestinal function recovery, the duration of biliary drainage and hospitalization were compared. Results When compared with the repair group, there were no significant differences in the amounts of postoperative biliary drainage [(310.0±112.0) vs. (264.0±144.0)ml] and abdominal cavity drainage [(42.0±25.0)ml vs. (125.0±195.0)ml)] (both P>0.05). However, gastrointestinal function recovery [(3.0±1.5)d vs. (4.7±2.0)d], durations of biliary drainage [(7.5±1.0)d vs. (12.7±5.4)d] and hospitalization [(9.5±1.5)d vs. (15.1±5.6)d] of the drainage group were significantly shorter than the repair group (P<0.05). No biliary strictures of cholangitis were detected in the two groups. Conclusion When compared with traditional repair, gastrobiliary drainage was a simpler, safer, and more effective therapeutic strategy for patients with iatrogenic distal common bile duct injury, and with a quicker recovery after treatment. Key words: Distal common bile duct; Iatrogenic injury; Gastrobiliary duct drainage