T-Tube Drainage Versus Primary Duct Closure After Open Common Bile Duct Exploration In Management of Choledocholithiasis

Abstract

Objective: To determine the outcomes of T-Tube drainage versus Primary Duct Closure after open common bile duct exploration in management of choledocholithiasis. Study Design: Quasi-Experimental study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Kharian Pakistan, from Aug 2019 to Jul 2022. Methodology: All patients aged 26-64 years of either gender and undergoing open Common Bile Duct exploration for choledocholithiasis, were recruited in the study. Group-A consisted of 30 patients who underwent T-tube drainage, while Group-B consisted of 30 patients who underwent primary ductal closure. Results: Total 60 patients were included in the study ranging from 26–64 years. There were 49(81.6%) females and 11(18.3%) males. Operative time in Group-A was 118.2±5.06 minutes, whereas, in Group-B it was 100.37±2.93 minutes. The duration of sub hepatic drain in Group-A was 16.37±1.75 days, and in Group-B was 7.47±2.71 days. In Group-A, hospital stay was 17.07±1.92 days, and in Group-B, the average hospital stay was 9.61±2.63 days. The total number of complications in Group-A was 05(16.7%). Total complications in Group-B were 02(6.67 %). Conclusion: Primary closure of CBD is a safe and effective alternative to T-tube drainage in selective patients. Our study recommends the use of the primary closure technique strongly except for cases where the distal patency of CBD is doubtful.