TY - JOUR
T1 - Long-term Outcome of Primary Closure After Laparoscopic Common Bile Duct Exploration Combined With Choledochoscopy
AU - Yi, Hee Jung
AU - Hong, Geun
AU - Min, Seog Ki
AU - Lee, Hyeon Kook
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/6/19
Y1 - 2015/6/19
N2 - Background: Primary closure after laparoscopic common bile duct exploration (LCBDE) is considered to be a safe alternative to T-tube drainage on the basis of the short-term outcome. However, little published data exist regarding the biliary complications at the long-term follow-up of primary closure versus T-tube drainage following LCBDE. Hence, the aim of this study is to assess the long-term outcome of primary closure after LCBDE. Materials and Methods: This is a retrospective study of 142 consecutive patients who underwent LCBDE combined with choledochoscopy for CBD stones. After LCBDE, the choledochotomy was closed by primary closure (group P) in 91 patients (64.1%) and with T-tube drainage (group T) in 51 patients (35.9%). The data on operative outcome and long-term biliary complications were compared between the 2 groups. Results: The mean operation time was significantly shorter in group P than group T (168.9±50.1 min for group P vs. 198.0±59.6 min for group T, P=0.002). The hospital stay was significantly shorter in group P than in group T (8.59±6.0 d for group P vs. 14.96±5.4 d for group T, P=0.001). Postoperative bile leak occurred in 2 patients (2.2%) in group P and 1 patient (2.0%) in group T. With a mean follow-up of 48.8 months, the stone recurrence rate in group P and group T were 4.4% and 5.9%, respectively (P=0.722). During the follow-up period, there was no sign of biliary stricture or other biliary complications in both groups. Conclusions: The long-term follow-up data on primary closure after LCBDE indicated a low incidence of recurrent stones, and no biliary strictures. Thus, primary closure after LCBDE with choledochoscopy is considered to be a safe and effective alternative to T-tube drainage in terms of long-term outcome.
AB - Background: Primary closure after laparoscopic common bile duct exploration (LCBDE) is considered to be a safe alternative to T-tube drainage on the basis of the short-term outcome. However, little published data exist regarding the biliary complications at the long-term follow-up of primary closure versus T-tube drainage following LCBDE. Hence, the aim of this study is to assess the long-term outcome of primary closure after LCBDE. Materials and Methods: This is a retrospective study of 142 consecutive patients who underwent LCBDE combined with choledochoscopy for CBD stones. After LCBDE, the choledochotomy was closed by primary closure (group P) in 91 patients (64.1%) and with T-tube drainage (group T) in 51 patients (35.9%). The data on operative outcome and long-term biliary complications were compared between the 2 groups. Results: The mean operation time was significantly shorter in group P than group T (168.9±50.1 min for group P vs. 198.0±59.6 min for group T, P=0.002). The hospital stay was significantly shorter in group P than in group T (8.59±6.0 d for group P vs. 14.96±5.4 d for group T, P=0.001). Postoperative bile leak occurred in 2 patients (2.2%) in group P and 1 patient (2.0%) in group T. With a mean follow-up of 48.8 months, the stone recurrence rate in group P and group T were 4.4% and 5.9%, respectively (P=0.722). During the follow-up period, there was no sign of biliary stricture or other biliary complications in both groups. Conclusions: The long-term follow-up data on primary closure after LCBDE indicated a low incidence of recurrent stones, and no biliary strictures. Thus, primary closure after LCBDE with choledochoscopy is considered to be a safe and effective alternative to T-tube drainage in terms of long-term outcome.
KW - choledochoscopy
KW - laparoscopic common bile duct exploration
KW - primary closure
UR - http://www.scopus.com/inward/record.url?scp=84931466511&partnerID=8YFLogxK
U2 - 10.1097/SLE.0000000000000151
DO - 10.1097/SLE.0000000000000151
M3 - Article
C2 - 25856136
AN - SCOPUS:84931466511
SN - 1530-4515
VL - 25
SP - 250
EP - 253
JO - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
JF - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
IS - 3
ER -