Study of Primary Closure of the Common Bile Duct for Choledocholithiasis.

Primary closure of the common bile duct in open laparotomy for common bile duct stones

“…We had two cases of bile leakage among the 17 patients (11.7%) in group PC (lasting 3 and 4 days), and one case (5.8%) in group TT, lasting 1 day; no extra care was required for these patients. The incidence of leakage was reported to be 14.3%–38%,,, and trivial leakage was shown in all patients with laparoscopic primary closure . There are so many differences in the reported incidence of bile leakage that consensus on a definition seems to be needed.…”

“…The number of postoperative hospital admission days in group PC was significantly lower than that in group TT, at 18.3 ± 12.7 days and 31.5 ± 5.6, respectively. Other authors have reported stays of 18.5–20.1 days and 36–37.8 days, respectively ,. Generally speaking, the number of hospital admission days in Japan is obviously higher than that in other countries, especially other western countries, including the United States.…”

“…It would be reasonable to choose primary closure to improve postoperative life and shorten hospital admission if possible, because there were no significant differences between primary closure and T‐tube insertion in complications and laboratory data ,…”

“…Therefore, open surgery is still the most familiar treatment for CBD stones. Clinical research on T‐tube insertion and primary closure of the CBD has been reported in the past two decades; however, there are few such current reports …”

“…Clinical research on T-tube insertion and primary closure of the CBD has been reported in the past two decades; [9][10][11] however, there are few such current reports. 12 In this study, our aim was to evaluate the usefulness of primary closure of the CBD, to avoid long hospital admissions, and to explore the indications for primary closure and open laparotomy treatment required to perform a T-tube-free operation.…”