Comparison Between Primary Suture And T-tube Drainage Of Common Bile Duct After Laparoscopic Exploration

Objective: to compare the clinical effect between primary suture and T-tube drainageof common bile duct after laparoscopic exploration of extrahepatic bile duct stones,andexplore the clinical experience and feasibility. Methods: The clinical data of50cases ofextrahepatic bile duct stones received laparoscopic common bile duct exploration astreatment in Liver laparoscopic surgery from Feb.2011to Feb.2013were analyzedretrospectively，There was used to the data of21cases underwent primary suture(PSgroup)and29cases underwent T-tube drainage(TD group). The paper compares indicatorsinclude the following： The operative time, intraoperative blood loss,hospitalizationcosts,normal gastrointestinal activity recovery time,postoperative ambulation time,postoperative fluid volume,drainage time，hospital stay after surgery and the incidence ofpostoperative complications(bile leakage, bile duct stricture, Indigestion, abdominalinfection, cholangitis, residual stones). Results: All patients were cured and dischargedfrom hospital，no fatal ease was noted.There were no differences in the demographiccharacteristics and clinical presentations between the two groups.In the primary closuregroup，two patients experienced bile leakage,one patients experienced residual stones andtwo patients experienced Indigestion, Respectively,three patients experienced bileleakage,one patients experienced residual stones and three patients experiencedIndigestion in the T-tube drainage group. In primary closure group, the hospitalizationcosts,normal gastrointestinal activity recovery time,postoperative ambulation time,postoperative fluid volume,drainage time and hospital stay after surgery were shorter thanthat in T-tube drainage group, the differences between the two groups were statistically significant(P <0.05). There were no statistical differences in the operative time,intraoperative blood loss and the incidence of postoperative complications between twogroups (P>0.05). Conclusions:In the condition of strict controlling the indication,theclinical effect of primary suture was better than T-tube drainage after laparoscopiccommon bile duct exploration and the advantage is obvious. This surgical approach is thebest choice for treatment of extrahepatic bile duct stones.