T-tube drainage versus primary closure after laparoscopic common bile duct exploration

Gurusamy, Kurinchi Selvan; Koti, Rahul; Davidson, Brian R

doi:10.1002/14651858.cd005641.pub3

Cited by 62 publications

(76 citation statements)

References 63 publications

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“…They found it to be feasible, safe, and cost-effective to perform such a closure after laparoscopic choledochotomy. A recent updated meta-analysis comparing T-tube drainage with primary closure after laparoscopic choledochotomy showed that there was no significant difference in serious morbidity rates between the two groups [21]. However, the operative time and hospital stay were significantly longer in the T-tube drainage group.…”

Section: Discussionmentioning

confidence: 99%

Primary Closure and Rate of Bile Leak following Laparoscopic Common Bile Duct Exploration via Choledochotomy

et al. 2015

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Background: Choledocholithiasis is traditionally managed by endoscopic retrograde cholangiopancreatography or T-tube insertion following common bile duct exploration. This study examined the efficacy and safety of primary duct closure following laparoscopic common bile duct exploration (LCBDE) via choledochotomy. Methods: Between September 2011 and September 2013, 157 consecutive patients underwent LCBDE via choledochotomy. Results: Of 157 LCBDE procedures, 138 (87.9%) were successfully completed with primary closure of the choledochotomy. Eight patients (5.1%) underwent closure with T-tube drainage after choledochotomy and 11 patients (7.0%) were converted to open surgery. The biliary tree was free of stones at the end of surgery in 154 patients (98.1%). Postoperative bile leak occurred in 6 patients (3.8%). The median follow-up period was 18 (2-33) months, with no evidence of further bile duct stones or bile duct stricture in any patients. Univariable analysis revealed that successful duct clearance (p = 0.010) and diameter of the common bile duct (p < 0.001) were two significant risk factors for bile leak. Conclusions: Primary duct closure following LCBDE is effective and safe for the management of choledocholithiasis. The postoperative bile leak rate may be low in skilled laparoscopic surgeons with a careful selection of patients.

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Section: Discussionmentioning

confidence: 99%

Primary Closure and Rate of Bile Leak following Laparoscopic Common Bile Duct Exploration via Choledochotomy

et al. 2015

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“…Согласно литературным данным при лапароскопической ревизии ОЖП средняя эффективность ревизии составила 80%, среднее значении осложнений менее 10% и смертность составила около 1% [21]. Наиболее часто встречаемые осложнения при лапароскопической ревизии холедоха: желчеистечение в брюшную полость, острый панкреатит, абсцесс брюшной полости, нагноение и гематома параумбиликальной раны, кровотечение из ложа желчного пузыря, прокола брюшной стенки для введения троакара или рассеченной спайки.…”

Section: эндоскопическая ретроградная панкреатохолангиорафия и эндоскunclassified

Modern technologies of treatment of choledocholithiasis

Serikbaiuly

Aimagambetov

2017

J CLIN MED KAZ

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The article presents data on the modern methods of treatment of cholecystisis complicated by choledocholithiasis. Methods of surgical treatment of common bile duct stones are increasing with the development of new technologies. Despite this, there is no clear consensus on the "gold standard" in treatment this disease. Old and new approaches include open surgical (including the mini-access method), laparoscopic and endoscopic procedures. The use of mini-invasive technology significantly reduces the number of postoperative complications, the period of postoperative rehabilitation of patients, and the mortality rate. The availability of technical resources and professional experience of experts may also play a crucial role in choice of treatment strategy.Key words: choledocholithiasis -surgical treatment. тҰжЫРЫМДАМА Мақалада холедохолитиазбен асқынған өт-тас ауруының жаңа емдеу әдістері келтірілген. Холедохолитиаздың хирургиялық емі жаңа технологиялардың дамуымен қоса көбеюде. Әлі күнге дейін бұл мәселенің «алтын стандартты» шешімі жоқ. Бұл патологияның жаңа және ескі емдеу әдістеріне ашық хирургиялық, лапароскопиялық және эндоскопиялық әдістер кіреді. Мини-инвазивті технологияларды қолдану науқастардың отадан кейінгі қалпына келу кезенің қысқартады, отадан кейінгі асқынуларды, сонымен қатар өлімділік көрсеткішін азайтады. Емдеу мекемелердің техникалық жабдықтануы және маманның кәсіби тәжірибесі мен біліктілігі емдеу әдісін таңдау кезінде шешуші рөль болуы мүмкін.Маңызды сөздер: холедохолитиаз -хирургиялық ем.современные технологии лечения холедохолитиАзА серікбайұлы д. 1, Аймагамбетов м.ж. РЕЗюМЕ В статье приведены данные о современных методах лечения желчнокаменной болезни, осложненной холедохолитиазом. Методы хирургического лечения холедохолитиаза увеличиваются с развитием новых технологий. До сих пор не существует четкого консенсуса от-носительно «золотого стандарта» в решении данной проблемы. Старые и новые подходы в лечении этой патологии включают открытые хирургические (в том числе и из мини-доступа), лапароскопические и эндоскопические методы. Применение мини-инвазивных технологий значительно уменьшает количество послеоперационных осложнений, уменьшает период послеоперационной реабилитации пациентов, со-кращает летальность. Доступность технических ресурсов клиник и профессиональный опыт специалистов, также может сыграть решающую роль в принятии решения тактики лечения.Ключевые слова: холедохолитиаз -хирургическое лечение.

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“…The external drainage of the common bile duct by the placement of a T-tube is a common practice after choledocholithotomy for patients with choledocholithiasis (1,2); however, its routine use is controversial (3)(4)(5). We have managed hundreds of patients with choledocholithiasis who required T-tube drainage after laparoscopic choledocholithotomy in recent years.…”

Section: Worsening Jaundice Induced By Biliary Drainagementioning

confidence: 99%