A Clinical Analysis of Open T-tube Choledochostomy

ABSTRACT

Traditionally, open choledochotomy with T-tube choledochostomy had been considered as the "gold standard" for choledocholithiasis. Recently, the frequency of performing the open choledochotomy with T-tube choledohostomy has decreased due to the progression of several less invasive procedures and laparoscopic technques, but until now open choledochotomy with T-tube choledochostomy is the most popular procedure in choledocholithiasis. Therefore we reviewed 126 cases who were treated with open choledochotomy with T-tube choledochostomy from January 1987 to June 1996 at our institution in order to inspect the several problematic points especially after T-tube removal. The results are summarized as follows, 1) The sex ratio of male to female was 11.29, and the average age was 59.6 years old. 2) 119 cases (94.4%) were biliary tract stone disease and 7 cases (5.6%) were non-calculous benign biliary tract disease. The most common etiologic disease was GB and CBD stone (37.3%). 3) Most of postoperative T-tube cholangiography was performed within 14 days (84.1%). 4) The number of patients containing some residual stone at postoperative T-tube cholangiography was 29 cases (23%). 14 of these patients were treated by Dormia-basket stone removal and its success rate was 85.7%. 5) The T-tube was removed within 2 months in 109 cases (86.5%). 6) The number of complications after T-tube removal were 8 cases (6.3%). All of them had bile peritonitis symptomes, and three of them were treated by reoperation. 7) The postoperative complications were noted in 27 cases (21.4%). and the most frequent complication is wound infection (25.8%). The postoperative mortality was noted in 1 case (0.8%).