A comparative study of choledochorraphy (primary repair) versus T-tube drainage after open choledochotomy
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 6, Issue 2
Abstract
Background: T-tube drainage used to be standard practice after surgical choledochotomy, but there is now a tendency in some canters to close the common bile duct primarily with stent in situ. This study was designed to compare the clinical results of primary closure(stent in situ) with T-tube drainage after open choledocotomy and assess the safety of primary closure with stent in situ for future application. Methods: This study was conducted at surgical Unit-3, National Institute Of Medical Sciences and Research-Jaipur from July 2017 to April 2018. Twenty patients were included in this study out of which 10 underwent primary closure with stent in situ and 10 T-tube placements. Main outcome measures were operating time, duration of hospital stay, and postoperative complications. Results: The age of patients in the study ranged from 25-75 years. There were 7 male while 13 female patients. Group-1 consisted of 10 patients underwent primary closure with stent in situ after choledocotomy, while Group-2 also consisted of 10 patients underwent T-tube drainage after duct exploration. Mean hospital stay in Group-1 patients was 7.63 days while in group 2 it was 13.6 days. Overall complication rate in group 1 was 20%, biliary leakage in 1 (10%), jaundice in 1 (10%). No re-exploration was required in Group-1. In Group-2 overall complication rate was 50%, biliary leakage in 2 (20%), jaundice in 1 (10%), dislodgement of T tube in 1 (10%) and wound infection in 1 (10%) patients. Re-exploration was done in one patient. Conclusion: Primary closure with stent in situ of Common Bile Duct (CBD) is a safe and cost-effective lternative procedure to routine T-tube drainage after open choledocotomy.
Authors and Affiliations
Sunil Kumar Agarwal, Pratik J Khandal
Keywords
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