Comparative study between different modalities of common bile duct closure after exploration and choledocho-lithotomy

Talaat, Mohamed Ahmedd; Attia, Ahmed Mohamed; Tohamy, Tohamy Abd Allah; Abdelaziz, Asaad Abdelrahman; Roshdy, Mchael Remon

doi:10.21608/mjmr.2023.229432.1504

Comparative study between different modalities of common bile duct closure after exploration and choledocho-lithotomy

Document Type : Original Article

Authors

¹ department of general surgery,faculty of medicine,Minia univesity ,Egypt

² Egypt, ElMinia university, faculty of medicine, associate professor of surgery .

³ General Surgery Department, Faculty of Medicine, Minia University

⁴ general surgery department,faculty of medicine,Minia university,Minia,EGYPT

⁵ general surgery department,faculty of medicine,Minia university,Mina,Egypt

10.21608/mjmr.2023.229432.1504

Abstract

Abstract

Background: Recent developments in radiologic, endoscopic, and surgical procedures have increased treatment options and made laparotomy unnecessary for evacuation of bile duct stones. Choledochotomy, stone extraction, confirmation of CBD clearance via passage of a soft catheter or dilator proximally or distally, cholangiography, and choledochoscopy are all part of standard CBD exploration process; choledochoscopy may be preferred; and finally, drainage procedures are recommended but are controversial due to options such as:

biliary drainage using a T-shaped tube. A biliary stent is implanted intraoperatively. Aim of study: The purpose of this study is to compare two methods of CBD closure following CBD exploration: T-shaped tube biliary drainage and biliary stent implantation. Patient and methods: Thirty patients were included, all of whom had undergone general surgery at ELMinia University Hospital. CBD stones found in every single one of them. Results: In situations of CBD stone with failure of stone extraction by ERCP, a common bile duct closure after intraoperative biliary stent implantation is safe and possible after choledocolithotomy in appropriate patients. findings demonstrate the efficacy of this method in terms of reduced length of stay in the hospital, decreased risk of complications such biliary leakage and biliary stricture, and reduced financial outlay. Conclusion: In this study we found that intraoperative CBD stenting after choledocholithotomy is better than T-tube drainage with shorter hospital stay, wound infection, good biliary drainage from CBD to the duodenum with less liability for postoperative bile leakage, equivalent operation time and mortality rate. Keywords: CBD exploration; choledocho-lithotomy; CBD stent.

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