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KMID : 0870420130170020070
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2013 Volume.17 No. 2 p.70 ~ p.74
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Ten-year experience on common bile duct exploration without T-tube insertion
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Lee Whan-Bong
Kwon Jung-Nam
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Abstract
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Backgrounds/Aims: Common bile duct (CBD) exploration has been a procedure necessary to remove stones which are not removable by endoscopic sphincterotomy (EST). T-tube was installed mainly in the concern of bile leakage after procedure. But T-tube itself can only cause bile peritonitis and thus, prolonged discomfort and care after operation. In addition, in the era of laparoscopy, T-tube insertion adds much operation time and is technically difficult for installation during the procedure.
Methods: Our case of open cholecystectomy and primary closure of CBD not leaving T-tube (n=28, group I) with reports dating from July 1998 to June 2007 is presented here to see whether primary closure without T-tube is safe as compared with T-tube inserted cases performed at the same center (n=15, group II). Operative cholangiography, CT scan, ultrasound and biochemical data were followed up for both groups and surveyed on operative complications as well to determine the outcomes.
Results: Bile leakage in 1, recurrent stone in 2 and obstructive jaundice in 1 were all considered during the follow up period among 28 group I patients (n=6), when compared to T-tube inserted group II patients with 2 bile peritonitis, 1 residual stones and 1 pancreatitis (n=4), showing no meaningful differences (p=0.07).
Conclusions: CBD exploration and direct primary closure not leaving T-tube is an acceptable operational option as recently tried in many choledochotomies.
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KEYWORD
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T-tube, Choledochotomy
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