Primary closure of common bile duct versus T-tube placement after open choledocholithotomy

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dc.contributor.authorSeervi, Manojen_US
dc.contributor.authorVerma, Deepaken_US
dc.contributor.authorChand, Nemien_US
dc.contributor.authorSharma, Sarthaken_US
dc.date.accessioned2020-11-18T10:04:35Z
dc.date.available2020-11-18T10:04:35Z
dc.date.issued2020-06
dc.description.abstractBackground: Choledocholithiasis is primarily managed by endoscopic retrograde cholangiopancreatography (ERCP) but in certain situation particularly large and impacted common duct stone, the procedure may not succeed and this small group of patients require either open or laparoscopic common bile duct exploration followed by T-tube insertion. Usually T-Tube cholangiogram is performed on 10th postoperative day and tube is removed on 12-14th day. Alternatively, primary closure of duct after post exploratory choledochoscopy to ensure duct clearance with or without biliary stent can be done.Methods: This study was performed on 25 patients of failed endoscopic extraction, subjected to open choledocholithotomy. Group A (n=7) had T-tube insertion whereas group B (n=18) had primary closure of duct after choledochotomy.Results: 19 patients had calculus cholecystitis whereas 6 patients had prior cholecystectomy and later developed choledocholithiasis. 52% patients had impacted stone and 40% had large stone as a cause of ERCP failure. Postoperative pyrexia, cholangitis, septicemia, sub-hepatic bilious drainage and postoperative hospital stay was higher in T-tube group as compared to primary closure group.Conclusions: Primary closure over the biliary stent after cholecystectomy and/or choledocholithotomy has less morbidity as compared to T-tube insertion and hence should be preferred choice in choledocholithiasis, provided stone free duct is ensured peroperative using choledochoscopy.en_US
dc.identifier.affiliationsDepartment of Surgery, Dr. S. N. Medical College, Jodhpur, Rajasthan, Indiaen_US
dc.identifier.citationSeervi Manoj, Verma Deepak, Chand Nemi, Sharma Sarthak. Primary closure of common bile duct versus T-tube placement after open choledocholithotomy. International Surgery Journal. 2020 Jun; 7(6): 1951-1955en_US
dc.identifier.issn2349-3305
dc.identifier.issn2349-2902
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/212959
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber6en_US
dc.relation.volume7en_US
dc.source.urihttps://dx.doi.org/10.18203/2349-2902.isj20202411en_US
dc.subjectCholedocholithiasisen_US
dc.subjectCholedocholithotomyen_US
dc.subjectPrimary closureen_US
dc.subjectT-tubeen_US
dc.titlePrimary closure of common bile duct versus T-tube placement after open choledocholithotomyen_US
dc.typeJournal Articleen_US
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