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Long-term Outcome of Primary Closure After Laparoscopic Common Bile Duct Exploration Combined With Choledochoscopy
- 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
- Ewha Authors
- 이현국; 민석기; 홍근
- SCOPUS Author ID
- 이현국; 민석기; 홍근
- Issue Date
- Journal Title
- SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES
- 1530-4515; 1534-4908
- vol. 25, no. 3, pp. 250 - 253
- laparoscopic common bile duct exploration; primary closure; choledochoscopy
- LIPPINCOTT WILLIAMS & WILKINS
- SCI; SCIE; SCOPUS
- 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 (168.950.1 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.
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