Abstract
Objective We are trying to investigate the possibility, safety, and benefits of replacing the role of T-tube by another more safe and effective procedure for biliary decompression in the case of common bile duct (CBD) exploration. Methods Our present study includes fifty consecutive patients who underwent a traditional CBD exploration due to choledocholithiasis. Patients were divided into 2 equal groups. In the 1st group, a spontaneously expelled Nelaton tube is placed in the CBD to aid in bile drainage to the duodenum, while in the 2nd group, a conventional T-tube is placed to decompress the CBD in the early postoperative (PO) days to a drainage bag. Operative and PO data as well as PO hospital stay time were recorded. All data were collected and statistically analyzed. Results The mean operative time and PO hospital stay days were significantly low (p value < 0.05) in the Nelaton tube drainage group compared with the T-tube drainage group. On the other hand, the mean time needed for the abdominal drain removal was significantly higher in the T-tube drainage group (p value < 0.05). Conclusion Nelaton tube with internal biliary drainage is effective and safer than T-tube drainage and it helps in reduction of the PO hospital stay time. In addition, it avoids all short-term complications of T-tube.
Highlights
Choledocholithiasis is the 2nd most common complication of gallbladder stone disease and its frequency is about 10–20 % in symptomatic gallstones as well as in 5 % of asymptomatic patients [1, 2]
Many reasons mentioned against the routine use of T-tube in the form of longer hospital stay, physical discomfort, the delayed return to ordinary activity and work, and the risk of track infection increase the need for analgesics, displacement of the tube, cholangitis, and bile leakage for a long time after T-tube removal
Inclusion criteria for this study include patients who are diagnosed as having common bile duct (CBD) stones with absence of endoscopic retrograde cholangiopancreatography (ERCP) facility or failure of stone extraction through ERCP, age >18 years and ≤ 70 years, ability to sign a consent form and undergo the study procedure, and American Society of Anesthesiology (ASA) score of I-III
Summary
Choledocholithiasis is the 2nd most common complication of gallbladder stone disease and its frequency is about 10–20 % in symptomatic gallstones as well as in 5 % of asymptomatic patients [1, 2]. Many reasons mentioned against the routine use of T-tube in the form of longer hospital stay, physical discomfort, the delayed return to ordinary activity and work, and the risk of track infection increase the need for analgesics, displacement of the tube, cholangitis, and bile leakage for a long time after T-tube removal. All these reasons in addition to other longterm complications could lead to high PO morbidity and mortality [2, 8]. Due to this argument about the hazards of T-tube, we offered in this
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