Primary Closure Following Laparoscopic Common Bile Duct Exploration Combined with Intraoperative Choledochoscopy and D-J Tube Drainage for Treating Choledocholithiasis
Miao Yu, Huanzhou Xue, Quan Shen, Xiao Zhang, Ke Li, Meng Jia, Jiangkun Jia, Jian Xu
Department of Hepatobiliary Surgery, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
Med Sci Monit 2017; 23:4500-4505
This study aimed to assess the clinical short-term results of a primary closure following laparoscopic common bile duct exploration (LCBDE) combined with intraoperative choledochoscopy and D-J tube drainage for choledocholithiasis treatment.
MATERIAL AND METHODS: Twenty-five patients (14 women and 11 men) who underwent LCBDE with primary duct closure and D-J tube drainage for choledocholithiasis were retrospectively enrolled. The D-J tube (4.7F×14 cm) was removed using a duodenoscope if there was no bile leakage. Before discharge, patients were examined for blood amylase. After discharge or D-J tube removal, all patients were routinely assessed for complications.
RESULTS: Mean operating time was 135±46 min (range, 78–195 min). Mean intraoperative blood loss was 71±24 mL (range, 25–110 mL). Total hospital stay was 6–9 days (mean, 8.04±1.37 days). Two patients experienced intraoperative bile leakage, which was stopped with re-suturing. None of these patients experienced postoperative bile leaks. Three patients had slight elevation of serum amylase before discharge but without pancreatitis signs. The successful clearance rate of stones was 100%. During 1-year follow-up, no recurrence or severe complications occurred.
CONCLUSIONS: A primary closure following LCBDE combined with intraoperative choledochoscopy and D-J tube drainage is safe and feasible for choledocholithiasis treatment.
Keywords: Blood Loss, Surgical, choledocholithiasis, Laparoscopy