Primary Closure Versus T-Tube Drainage Following Laparoscopic Common Bile Duct Exploration in Patients With Previous Biliary Surgery

Wan, Zhang; Wang, Xuzhen; Fu, Nantao; Li, Yong; Xiao, Weidong; Donghui, Zheng

doi:10.1177/0003134820947396

Cited by 16 publications

(13 citation statements)

References 28 publications

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“…In the present study, 23 patients in the PC group had previously undergone cholecystectomy. The safety and feasibility of the treatment have also been demonstrated in a previous study [ 29 ].…”

Section: Discussionmentioning

confidence: 74%

Safety and Feasibility of Primary Closure Following Laparoscopic Common Bile Duct Exploration for Treatment of Choledocholithiasis

Xiang

Liu

et al. 2022

World j. surg.

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Background T-tube drainage following laparoscopic common bile duct (CBD) exploration may lead to T-tube displacement and water–electrolyte disorders, affecting patients’ quality of life. In particular, biliary peritonitis may develop in a small number of patients after T-tube removal, requiring reoperation. This prospective cohort study was performed to investigate the safety and feasibility of primary closure following laparoscopic CBD exploration for the treatment of choledocholithiasis. Methods Patients who were treated for choledocholithiasis by laparoscopic CBD exploration with primary closure from January 2019 to March 2022 comprised the PC group (n = 145). Patients who were treated for choledocholithiasis by laparoscopic CBD exploration with T-tube drainage during this period comprised the TD group (n = 153). Perioperative and follow-up outcomes were collected and statistically analyzed. Results The TD and PC groups showed significant differences in the operation time (124.6 ± 40.8 vs. 106 ± 36.4 min, P = 0.000) and postoperative hospital stay (7.1 ± 2.6 vs. 5.9 ± 2.0 days, P = 0.000). No significant difference was observed in terms of blood loss, the ratio of conversion to laparotomy, and postoperative parameters. Preoperative albumin and total bilirubin levels were the risk factors of bile leakage after surgery. No patients developed CBD stricture or carcinogenesis, The rates of residual and recurrent stones in the TD and PC groups were 1.97% vs. 1.40% and 1.31% vs. 1.40%, respectively, with no significant difference (P = 1.000 for both). Conclusions Primary closure following laparoscopic CBD exploration is safe and feasible for selected patients with choledocholithiasis.

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Section: Discussionmentioning

confidence: 74%

Safety and Feasibility of Primary Closure Following Laparoscopic Common Bile Duct Exploration for Treatment of Choledocholithiasis

Xiang

Liu

et al. 2022

World j. surg.

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“…Intrahepatic and extrahepatic bile duct stones are very common diseases in hepatobiliary surgery, and surgical treatment is the main treatment method [ 16 ]. When intrahepatic and extrahepatic bile duct stones are treated surgically, the T-tube is usually placed in the common bile duct for drainage [ 17 ]. Indwelling T-tube can also achieve the purpose of bile drainage, bile duct support, and bile duct pressure reduction, thus reducing postoperative inflammation, edema, and bile outflow symptoms [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Internet+Continuous Nursing Mode in Home Nursing of Patients with T-Tube after Hepatolithiasis Surgery

Peng

Wan

et al. 2022

Computational and Mathematical Methods in Medicine

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This study was to explore the effect of a continuous nursing model based on the mobile Internet in the home nursing of patients with T-tube after hepatolithiasis surgery. A continuous nursing system based on the mobile Internet was constructed, and 94 discharged patients with T-tube after biliary tract surgery were selected as the study subjects. The differences of complication rate, referral rate, nursing satisfaction, self-care ability, and quality of life score through the 36-item short form health survey (SF-36) after routine health education nursing (control group, n = 47 ) and continuous nursing mode based on the Internet (observation group, n = 47 ) were explored. The results showed that the success rate of the continuous nursing system based on mobile Internet in processing user requests was 96.2%. After nursing, the total complication rates of the control group and the observation group were 34.0% and 6.4%, the total satisfaction rates were 42.6% and 87.2%, and the referral rates were 23.4% and 6.4%, respectively, and the difference was statistically significant ( P < 0.05 ). After nursing, the scores of self-care ability and SF-36 quality of life in the observation group were higher than those in the control group, and the difference was statistically significant ( P < 0.05 ). In summary, the continuous nursing platform based on mobile Internet technology can meet the needs of users, and the nursing mode can significantly improve the home self-care ability of discharged patients with T-tube after surgery and improve the nursing effect, which is conducive to the rehabilitation of patients.

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“…Some hospitals cooperate with medical device manufacturers to produce special internal drainage tubes and these are then applied in patients. Certain hospitals use an ordinary 16F silicone tube to create a barb fitting to prevent the tube falling out, while others use a catheter to prepare an internal drainage tube ( 2 , 11 ). Another important issue is how to place the internal drainage tube safely in a suitable position.…”

Section: Discussionmentioning

confidence: 99%

Application of an internal drainage tube in laparoscopic common bile duct exploration

Dong

Liu

Luo

et al. 2021

Med Int

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Choledocholithiasis is a common disease of the biliary system. the traditional surgical method for this is to remove the gallbladder, open the common bile duct, remove the stones and place a t-tube in the common bile duct for drainage. Common bile duct exploration usually requires a t-tube. Without a t-tube, there is a risk of bile leakage due to pressure in the bile duct. after the t-tube is placed, patients experience some form of discomfort and inconveniences with daily life, and there is also a risk of accidental detachment, as well as a risk of bile leakage when the t-tube is removed. In severe cases, patients may need to be hospitalized again. With advancements being made in surgical instruments and technology, laparoscopic common bile duct exploration has been widely used. Due to the carbon dioxide pneumoperitoneum, laparoscopic common bile duct exploration requires a long period of time for t-tube sinus formation compared with open surgery. therefore, the extubation time needs to be prolonged in laparoscopic common bile duct exploration. the use of an internal drainage tube may be used in order to avoid the aforementioned disadvantages. Since 2012, the authors have performed laparoscopic common bile duct exploration with the placement of an internal drainage tube for the treatment of common bile duct stones, and have completed >160 surgeries. the present study provides a summary of the data of these 160 cases. the 160 patients underwent laparoscopic cholecystectomy. Following the removal of the stones, an internal drainage tube was placed, and the common bile duct incision was primary sutured. all patients were discharged, and there were no complications, such as biliary leakage, biliary bleeding and biliary stricture. on the whole, the present study demonstrates that where possible, the placement of an internal drainage tube in laparoscopic common bile duct exploration is safe and reliable, and may be used to avoid the risk of bile leakage without a t-tube, any inconveniences for patients, and the risk of bile leakage following the removal of the t-tube.

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Primary Closure Versus T-Tube Drainage Following Laparoscopic Common Bile Duct Exploration in Patients With Previous Biliary Surgery

Cited by 16 publications

References 28 publications

Safety and Feasibility of Primary Closure Following Laparoscopic Common Bile Duct Exploration for Treatment of Choledocholithiasis

Safety and Feasibility of Primary Closure Following Laparoscopic Common Bile Duct Exploration for Treatment of Choledocholithiasis

Internet+Continuous Nursing Mode in Home Nursing of Patients with T-Tube after Hepatolithiasis Surgery

Application of an internal drainage tube in laparoscopic common bile duct exploration

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