Introduction: One of the safe & feasible methods for the management of extra-hepatic bile duct calculi is laparoscopic bile duct exploration. Around 10-15% of the subjects who have surgery due to gallstone disease have choledocholithiasis associated with it. A standard procedure to prevent bile escape from the choledochotomy site is conventionally postoperative T-tube drainage following common bile duct exploration.
Aims & Objectives: Comparative study of laproscopic common bile duct exploration using stent drainage versus t- tube drainage.
Material & Methods: The study involved a total of 46 subjects with choledocholithiasis, who were categoryed in 2 categorys. Category I as a drainage category of stents and Category 2 as a drainage category of T-tubes. The subjects in both classes underwent LCBDE surgery. Of the 46 subjects operated, 23 were in category I (stent drainage category) and 23 were in category 2 (T-tube drainage category).
Results: 23 subjects were categoryed in the stent drainage and T-tube drainage categories, respectively. In both classes, no perioperative or postoperative mortality was reported. Subjects had hypertension in stent drainage category 4 (17.39 percent) and 5 (21.73 percent) suffered from diabetes as a comorbid disease, while 2 (8.69 percent) subjects had jaundice. Four (17.39 percent) subjects with diabetes and three (13.04 percent) subjects with jaundice were found in T-tube drainage category 3 (13.04 percent) with hypertension. In both classes, no statistically significant difference was found. In terms of organisational results and outcomes, statistically significant variations were found in both categorys (Table 3). Mean operating time was 103± 22.4 in category I while 127±32.7 (P value < 0.005) in category II. In the Stent Drainage Category, blood loss during procedure was 22±3.7 ml, while in the T-tube drainage category it was 38±5.1 (P value < 0.005).
Conclusion. After laparoscopic choledochotomy, primary closure of the bile duct with spontaneously reversible biliary stent placement is a viable and practicable process. With spontaneously removable biliary stents, less surgery time, less bleeding and less intestinal complications have been observed.
Keywords: stent drainage, T- tube drainage, choledochotomy
Primary duct closure versus T-tube drainage after laparoscopic common bile duct exploration: a meta-analysis
