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

Objective:To compare the clinical effects of primary suture and T-tube drainage after laparoscopic common bile duct exploration and explore the feasibility of primary suture。Methods:A retrospective analysis of 71 cases of laparoscopic common bile duct exploration from December 2014 to December 2016,including 33 cases of primary suture(group PS),T tube drainage in 38 cases(group TD)Results:Two groups of patients on demographic characteristics and ASA classification had no difference.There was no significant difference in the average diameter of the common bile duct(11.6±2.4mm、11.4±2.1mm),the average number of common bile duct stones(2.3±1.1、2.3±0.9)and the total bilirubin(47.3±42.7μmol/L 、 56.4±52.4μmol/L)between the primary suture group and T tube drainage group.(P>0.05).In addition,there was no difference in abdominal cavity drainage time(4.0±1.6d、4.5±1.4d)(P>0.05).However,the operative time、flatus time、postoperative hospital stay were(112.3±27.6)minutes、(2.4±0.6)days、(5.1±1.6)days in PS group,which was shorter than those of(131.1±22.6)minutes、(3.0±0.8)days、(5.9±1.8)days in TD group.In the primary closure group,three patients experienced bile leakage.Patients with biliary fistula were cured by prolonging the drainage time.One patient experienced infected surgical incision.In the T-tube drainage group,two patients experienced bile leakage.T tube was pulled out at 5 weeks after surgery in 1 case.And one patient had acute pancreatitis postoperative.No fatal case was noted.There were also no differences in the postoperative complications。Conclusion:Compared with TD group,the operation time,flatus time,and postoperative hospital stay days were significantly reduced in PS group.By controlling the surgical indications,primary closure after laparoscopic common bile duct exploration does not increase the incidence of postoperative complications.It is safe,efficient and feasible.