Clinical Consideration of Choledocholithiasis Treatment: Analysis of Primary Closure versus T-tube Drainage after Choledochotomy
Journal of the Korean Surgical Society
;
: 55-60, 2003.
Article
in Korean
| WPRIM
| ID: wpr-68196
ABSTRACT
PURPOSE:
The placement of a drainage tube in the common bile duct, following a choledochotomy, has become accepted as routine procedure since it was first reported, by Abbe, in 1892. However, many complications are associated with T-tube drainage, such as bile peritonitis after its removal, accidental dislodgement, bile leakage from the T-tube track and a high incidence of postoperative bacteremia, have been reported. This study was designed to evaluate the primary closure as a suitable surgical technique in placce of T-tube drainage following a choledochotomyMETHODS:
Between January and December 2002, primary closures were performed in 41 cases and T tube drainage in 112, following a choledochotomy. These cases were divided into 2 groups (group A primary closure, and group B T-tube drainage). The medical records of the patients were reviewed, and the following data analysed -age, sex, preoperative laboratory value, intraoperative finding, postoperative laboratory value, complication, and days of postoperative hospital stay.RESULTS:
There were no significant differences observed in the data of the investigated parameters, with the exception of the mean post-operative hospital stay. The mean post- operative hospital stays were 11.82 and 18.08 days in groups A and B (P=0.0034), respectively. The complication rates of each group showed no statistical difference. However bile peritonitis or bile leakage after T-tube removal developed 5 cases from group B. There were 2 and 5 deaths due to MODS & ARDS, respectively.CONCLUSION:
A primary closure, following a choledochotomy, may be a suitable alternative technique to T-tube drainage under reasonable conditions.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Peritonitis
/
Bile
/
Drainage
/
Medical Records
/
Incidence
/
Bacteremia
/
Common Bile Duct
/
Choledocholithiasis
/
Length of Stay
/
Multiple Organ Failure
Type of study:
Incidence study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Surgical Society
Year:
2003
Type:
Article
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