Primary common bile duct closure and antegrade stent insertion in choledocholithiasis patients

Park, Il Young; Sung, Gi Young; Song, Moo Hyung; Lee, Do Sang; Kim, Wook; Won, Jong Man

Abstract

BACKGROUND/AIMS: After common bile duct exploration, placement of drainage tube was accepted as the standard treatment for choledocholithiasis patients. But placement of the drainage tube may create several complications including bile leakage. We undertake primary common bile duct closure with temorary antegrade stent after common duct exploration in cholodocholithiasis patients to prevent the complications due to drainage tube.
METHODS
Between Febuary 1999 and January 2001, 38 patients underwent primary common bile duct closure with antegrade stent after common bile duct exploration without the placement of drainage tube. The study population included 19 men and 19 women with a median age of 61 years (range 26 to 84 years). Laparoscopic choledochotomy was perfromed in 10 patients . Open choledochotomy was performed in 28 patients. Antegrade stent was inserted using choledochoscope.
RESULTS
Postoperative hospital stay of the laparoscopic choledochotomy patients were 6 +/- 1.8 days and of the open choledochotomy patients were 10 +/- 4.3 days. Antegrade stent was spontneously passed through the papailla and disappeared in the abdomen in 22 +/- 12.4 days postoperatively. Treatment-related morbidity was seen in 2 cases ( 5.3 %).
CONCLUSION
Primary common bile duct closure with temporary antegrade stent after common bile duct exploration is a safe, effective alternative to the routine T-tube drainage in the choledocholithiasis patients.