Long-term Outcome of Primary Closure After Laparoscopic Common Bile Duct Exploration Combined With Choledochoscopy

Yi, Hee Jung; Hong, Geun; Min, Seog Ki; Lee, Hyeon Kook

doi:10.1097/sle.0000000000000151

Cited by 42 publications

(29 citation statements)

References 24 publications

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“…Bile duct stricture is a main concern for patients who have undergone LCBDE. Yi et al 25 reported no bile duct strictures in patients who underwent T-tube or primary closure after LCBDE at a median follow-up of 48.8 months. In the present study, only a mild bile duct stricture occurred in one patient in the primary closure group.…”

Section: Discussionmentioning

confidence: 99%

Primary closure with knotless barbed suture versus traditional T-tube drainage after laparoscopic common bile duct exploration: a single-center medium-term experience

et al. 2019

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Objective: Primary closure of the common bile duct (CBD) after laparoscopic CBD exploration (LCBDE) is a technical challenge. The present study was performed to evaluate the safety and effectiveness of this surgical method. Methods: This retrospective study of surgical efficacy and safety involved 79 patients who underwent primary CBD closure with a knotless unidirectional barbed suture or traditional T-tube drainage after LCBDE for CBD stones. Results: The average suturing time, operation time, and postoperative hospital stay were significantly shorter in the primary closure group than T-tube group. There were no significant differences in the mean diameter of the CBD, number of stones, or incidence of postoperative complications between the two groups. No patients developed recurrence of CBD stones during the median follow-up of 21.5 months. Conclusions: After LCBDE and intraoperative choledochoscopy, primary closure with knotless unidirectional barbed sutures is a safe and effective therapeutic option for patients with cholelithiasis and concurrent CBD stones. This is especially true when the CBD is dilated more than 8 mm.

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Section: Discussionmentioning

confidence: 99%

Primary closure with knotless barbed suture versus traditional T-tube drainage after laparoscopic common bile duct exploration: a single-center medium-term experience

et al. 2019

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“…Several comparative studies and meta-analysis have demonstrated that primary closure is at least as effective and safe as T-tube drainage [8, 34, 35], even in emergency operation [36] and elderly patients [37]. Long-term outcome also shown that primary closure after LCBDE had a low incidence of recurrent stones, and no biliary strictures [5]. Thus, primary closure after LCBDE with choledochoscopy is considered to be a safe and effective alternative to T-tube drainage.…”

Section: Discussionmentioning

confidence: 99%

“…With the development of laparoscopic equipment and technology, laparoscopic common bile duct exploration (LCBDE) has been widely used in clinical practice [1–4]. Many previous studies have demonstrated that LCBDE is safe and effective in treatment of CBD stone [2, 4, 5]. After LCBDE, primary closure or T-tube drainage will be applied according to the condition of CBD and experience of surgeon.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for bile leakage after primary closure following laparoscopic common bile duct exploration: a retrospective cohort study

et al. 2017

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AbstractionBackgroundPrimary closure following laparoscopic common bile duct exploration (LCBDE) has been widely adopted because of the efficacy and safety in treatment of common bile duct (CBD) stones. However, the risk factors for bile leakage, the most common complication after primary closure, has not been clarified yet.MethodsA retrospective cohort study of patients who underwent LCBDE with primary closure after choledochotomy between Feb. 2012 and Jun. 2016 was performed. Risk factors for bile leakage were identified by logistic regression inculding demographic factors, preoperative condition and surgical details.ResultsBetween Feb. 2012 and Jun. 2016, a total of 265 LCBDE procedures were applied in our hospital and 141 patients with primary closure were included in this study. Bile leakage occurred in 11.3% (16/141) of these patients, and happened more frequently in patients with slender CBD (<1 vs ≥1 cm, 31.6% vs 7.0%, p = 0.04) and those managed by inexperienced surgeons (initial 70 cases vs later cases, 17.1% vs 5.6%, p = 0.04). After multivariable regression, the diameter of CBD [OR 95% CI, 3.799 (1.081–13.349), p = 0.04] and experience of surgeons [OR 95% CI, 4.228 (1.330–13.438), p = 0.03] were significantly related to bile leakage.ConclusionSlender CBD and inexperienced surgeons were the high risk factors for bile leakage after primary closure following LCBDE.

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“…However, patient discomfort caused by T-tube drainage remains the Achilles heel of this technique. Therefore, many surgeons try to perform LCBDE with primary closure, which shows a significant reduction in hospital stay and duration of operation with similar complication rates between LCBDE and T-tube drainage[13][14][15]. T-tube-free LCBDE could result in laparoscopic procedures becoming the optimal treatment for CBD stones.…”

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confidence: 99%

Laparoscopic management after failed endoscopic stone removal in nondilated common bile duct

Zang

Yin

Zhang

et al. 2016

International Journal of Surgery

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Long-term Outcome of Primary Closure After Laparoscopic Common Bile Duct Exploration Combined With Choledochoscopy

Cited by 42 publications

References 24 publications

Primary closure with knotless barbed suture versus traditional T-tube drainage after laparoscopic common bile duct exploration: a single-center medium-term experience

Primary closure with knotless barbed suture versus traditional T-tube drainage after laparoscopic common bile duct exploration: a single-center medium-term experience

Risk factors for bile leakage after primary closure following laparoscopic common bile duct exploration: a retrospective cohort study

Laparoscopic management after failed endoscopic stone removal in nondilated common bile duct

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