T-Tube Versus Biliary Stent as Decompression Procedure after Open Common Bile Duct Exploration in Patients of Choledocholithiasis
Journal Title: New Indian Journal of Surgery - Year 2017, Vol 8, Issue 2
Abstract
Background: Open biliary surgery followed by Ttube drainage is still a treatment of choice in patients of choledocholithiasis in many hospitals of developing world. The use of T-tube is not without complications. There are limited studies comparing efficacy of internal biliary stents versus T-tube in open CBD exploration to prevent T-tube complications. The present study assesses clinical short term results in patients who underwent open CBD exploration using a biliary stent versus a T-tube decompression method. Objectives: To compare the clinical outcomes in patients who underwent open CBD exploration using a biliary stent versus as a T-tube decompression method. Material and Methods: This prospective randomized controlled study was conducted on 50 consecutive patients undergoing open CBD exploration in the Department of Surgery, Government Medical College and Hospital, Chandigarh from June 2012 to October 2014. Patients were randomly allocated into two groups of 25 each to use of a biliary stent (Group A) (Indovasive, India) or a Kehr’s T-tube (Group B), following open CBD exploration. Results and Analysis: Baseline characteristics of both the groups were comparable. Surgical site wound infection was observed in 64% of group B patients as compared to 4% in group A (p=0.003). There was statistical significant difference in postoperative stay in hospital for patients in Group A (6±3.1days) as compared to Group B (9.6±5.3days). Postoperative VAS was significantly low in group A as compared to group B on 7th postoperative day (p=0.018). 3 patients in group B had retained CBD stone as compared to none in group A. 4 patients underwent readmission and 1 patient required reoperation in group B as compared to 1 readmission and no reoperation in group A. Conclusion: primary closure of CBD over biliary stent appeared safe and effective with lesser rate of surgical site wound infections, shorter postoperative hospital stay, few readmission rate and less postoperative discomfort in hospital settings where either laparoscopic CBD exploration facility or expertise are not available.
Authors and Affiliations
Shourabh Sinha
Keywords
Related Articles
- EP ID EP470967
- DOI 10.21088/nijs.0976.4747.8217.10
- Views 127
- Downloads 0
Prevalence and Surgical Management of Inguinal Hernia in a Tertiary Care Teaching Hospital in A Rural Area: A Retrospective Study
Background: The repair of inguinal hernia is the often-performed surgical operation worldwide [1]. It is the common condition among the people and affects around 27% - 43% of males and 3% - 6% of females of the world pop...
A Prospective Study of a Cost-Effective Method for Prevention of Incisional Hernia in Subcostal and Lumbar Incisions by Use of Nylon Loop, Intermittent Mass Closure
Background and Objective: Occurrence of incisional hernia in subcostal incisions (used mainly for open cholecystectomy and liver surgery) and lumbar incisions (used mainly for nephrectomy and pyelolithotomy) is relativel...
The Role of Upper GI Endoscopy in the Diagnosis and Treatment of Chronic Abdominal Pain in A Rural Hospital Set UP
Abdominal pain is one of the most common symptoms patients present in surgical outpatient department. It may be associated with other symptoms which sometime point towards a working diagnosis. But many a time because of...
A Prospective Study on treatment of Perianal Fistula by Video Assisted Anal Fistula Treatment (VAAFT)
Background: Video-assisted anal fistula treatment (VAAFT) is a novel minimally invasive and sphinctersaving technique for treating complex fistulas. The present study was planned with an objective to asses the late post...
Risk Factors Responsible to Surgical Site Infections Following Emergency non – Traumatic Exploratory Laparotomy
Background: Multiple risk factors and perioperative characteristics can increase the likelihood of superficial surgical site infections. Research has shown that patient factors, surgical techniques, skin preparation, tim...