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19 September 2017 : Clinical Research  

Primary Closure Following Laparoscopic Common Bile Duct Exploration Combined with Intraoperative Choledochoscopy and D-J Tube Drainage for Treating Choledocholithiasis

Miao Yu1ACE, Huanzhou Xue1ACE, Quan Shen1BC, Xiao Zhang1BD, Ke Li1BF, Meng Jia1B, Jiangkun Jia1BE, Jian Xu1BE

DOI: 10.12659/MSM.903753

Med Sci Monit 2017; 23:4500-4505

Abstract

BACKGROUND: This study aimed to assess the clinical short-term results of a primary closure following laparoscopic common bile duct exploration (LCBDE) combined with intraoperative choledochoscopy and D-J tube drainage for choledocholithiasis treatment.

MATERIAL AND METHODS: Twenty-five patients (14 women and 11 men) who underwent LCBDE with primary duct closure and D-J tube drainage for choledocholithiasis were retrospectively enrolled. The D-J tube (4.7F×14 cm) was removed using a duodenoscope if there was no bile leakage. Before discharge, patients were examined for blood amylase. After discharge or D-J tube removal, all patients were routinely assessed for complications.

RESULTS: Mean operating time was 135±46 min (range, 78–195 min). Mean intraoperative blood loss was 71±24 mL (range, 25–110 mL). Total hospital stay was 6–9 days (mean, 8.04±1.37 days). Two patients experienced intraoperative bile leakage, which was stopped with re-suturing. None of these patients experienced postoperative bile leaks. Three patients had slight elevation of serum amylase before discharge but without pancreatitis signs. The successful clearance rate of stones was 100%. During 1-year follow-up, no recurrence or severe complications occurred.

CONCLUSIONS: A primary closure following LCBDE combined with intraoperative choledochoscopy and D-J tube drainage is safe and feasible for choledocholithiasis treatment.

Keywords: Blood Loss, Surgical, choledocholithiasis, Laparoscopy

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750