Biliary Manometry in Patients with Common Bile Duct Stones

Baek, Jong Min; Lee, Do Sang; Kim, Tae Hyoung; Sung, Gi Young; Kim, Wook; Park, Il Young; Won, Jong Man

Abstract

BACKGROUND/AIMS: The conventional treatment of patients with common bile duct (CBD) stones was to insert a T-tube via the duct after stone removal. But since the placement of T-tubes resulted in a lot of complications, a few alternative methods have been suggested lately, such as primary closure or intraductal drainage etc. Deciding whether to perform primary closure or to insert a stent or a T-tube is usually based on objective findings such as inspection, palpation or intraoperative cholangiogram. We made a study using the intraoperative biliary manometry as an objective indicator in decision making among the procedures.
METHODS
The study was based on 23 patients (10 male, 13 female) who underwent common bile duct exploration for stone removal from March 2002 to May 2003. The basal pressure and frequency of phasic contraction of the Sphincter of Oddi were measured intraoperatively by manometry
RESULTS
Primary closure after CBD exploration was performed in 15 cases, intraductal drainage in the remaining 8 cases. No complication such as bile leakage or postoperative obstructive jaundice was observed.
CONCLUSION
The intraoperative biliary manometry is a simple and useful tool that can be used as an indicator in deciding whether to perform a drainage procedure after common bile duct stone removal.