Laparoscopic Bile Duct Exploration Via Choledochotomy Followed By Primary Duct Closure Is Feasible And Safe For The Treatment Of Choledocholithiasis

Objective: To explore the safety and reliability of laparoscopic choledochotomy in the treatment of choledocholithiasis.Conventional choledocholithotomy was performed with T-tube drainage,but the incidence of complications(including biliary leakage)was10.5%-20%.To investigate the safety and efficacy of laparoscopic common bile duct exploration(LCBDE)with primary suture.Methods: The clinical data of 80 patients with LCBDE from October 2017 to December 2019 were analyzed retrospectively.The basic preoperative data,intraoperative clinical data,postoperative clinical data and postoperative complication rate of laparoscopic common bile duct exploration.The catheters of all patients were essentially closed.Results: Transabdominal CBD exploration was successfully performed in 80 patients.The time consuming and blood loss of PS group were vs TD(124.84 ± 18.07 min vs 183.75 ± 18.139 min,46.46 ±28.437 ml vs 92.64±25.567ml),the data of PS group were significantly higher than those of TD group(P < 0.05,see Table 2).Comparison of postoperative data: Recovery of gastrointestinal function(PS group 1.89±0.847 days vs TD group 4.24±1.071 days),time of extubation(PS group 4.16±0.979 days vs TD group 67.98±10.367 days),time of hospitalize(PS group 7.27±1.446 days vs TD group 11.68±2.378 days),volume of infusion(PS group 1659.50±75.256ml/d vs TD group 2257.25±231.20ml/d),there was significant difference between the two groups(P < 0.05).There was no significant difference in postoperative complications between the two groups(P > 0.05).Conclusion:The primary catheter closure after LCBDE is safe and can be used as a routine alternative to T tube insertion.Hospitalize is shorter and incidence rate is lower.