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Surgical Endoscopy
Published in: Surgical Endoscopy 5/2016

01-05-2016

Eleven years of primary closure of common bile duct after choledochotomy for choledocholithiasis

Authors: Nuria Estellés Vidagany, Carlos Domingo del Pozo, Nuria Peris Tomás, Jose Ángel Díez Ares, Antonio Vázquez Tarragón, Francisco Blanes Masson

Published in: Surgical Endoscopy | Issue 5/2016

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Abstract

Background

The choice of surgical technique to extract stones from the common bile duct (CBD) depends on local experience, anatomical characteristics and also on the size, location and number of stones. Most authors consider choledochotomy an alternative to failed transcystic exploration, although some use it exclusively. Although the CBD is traditionally closed with T-tube drainage after choledochotomy, its use is associated with 11.3–27.5 % morbidity. This study examined the efficacy of laparoscopic CBD exploration (LCBDE) with primary closure for the treatment of CBD stones using intraoperative cholangiography (IOC).

Methods

Retrospective study of 160 patients who underwent LCBDE with primary closure after choledochotomy between January 2001 and December 2012.

Results

The diagnosis of choledocholithiasis was definitively made in all cases by IOC. The overall complication rate was 15 % and the biliary complication rate was 7.5 %. Bile leakage was reported in 11 patients (6.8 %). In over half the cases (63.6 %), no further action was required and the leak closed spontaneously. Six patients were reoperated (3.75 %), two for bile peritonitis and four for haemoperitoneum. The success rate for stone clearance was 96.2 %. The mortality rate and CBD stricture rate were 0 %.

Conclusion

Primary closure after choledochotomy to clear stones from the CBD is a safe technique that confers excellent results and allows one-stage treatment.
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Metadata
Title
Eleven years of primary closure of common bile duct after choledochotomy for choledocholithiasis
Authors
Nuria Estellés Vidagany
Carlos Domingo del Pozo
Nuria Peris Tomás
Jose Ángel Díez Ares
Antonio Vázquez Tarragón
Francisco Blanes Masson
Publication date
01-05-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 5/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4424-2

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