The efficacy and safety of laparoscopic common bile duct exploration with primary duct closure for cholecystolithiasis combined with choledocholithiasis

Abstract

Abstract Introduction: Cholecystolithiasis combined with choledocholithiasis is a common disease. Surgery is a safe and effective treatment method. In terms of the management of the common bile duct, T-tube drainage (TTD) and primary duct closure (PDC) are two methods for repairing the bile duct after laparoscopic common bile duct exploration (LCBDE). So far, there is still significant controversy over the choice of two surgical methods. This study analyzes the efficacy and safety of two bile duct management methods in LCBDE surgery. Materials and Methods: The clinical data of 157 patients who received LCBDE treatment in our hospital from January 2019 to January 2022 were analyzed retrospectively. All patients were divided into primary duct closure group (PDC group) and T-tube drainage group (TTD group) according to different treatment methods of common bile duct. The demographic factors, preoperative conditions, surgical details and postoperative complications were compared. Results: Compared with TTD group, PDC group had fewer number of stones and Diameter of stones (P<0.05). In the Diameter distribution of CBD, the proportion of mild expansion group (10-15mm) was higher (P<0.05). In PDC group, ALT and AST decreased more rapidly after surgery(P<0.05). PDC group had shorter operation time, less volume of drainage, and shorter extubation time, shorter postoperative hospital stay and less hospitalization cost(P<0.05). Conclusions: PDC is suitable for patients with small and fewer common bile duct stones, fewer number, and moderate expansion of the common bile duct. PDC is a safe and feasible treatment for cholecystolithiasis combined with choledocholithiasis.