Safety and efficacy of primary closure in patients with normal diameters of common bile duct after laparoscopic common bile duct exploration / 中华肝胆外科杂志

ABSTRACT

Objective:To study the safety and efficacy of primary closure of non-dilaed common bile ducts (CBD) after laparoscopic common bile duct exploration.Methods:A retrospective study was conducted on the clinical data of 120 patients who underwent primary closure of CBD after laparoscopic CBD exploration (LCBDE) at the Shengjing Hospital of China Medical University from April 1, 2014 to November 30, 2019. There were 44 males and 76 females, aged 22.0 to 88.0 years, (average age of 57.2 years). These patients were divided into the dilated CBD group (diameter of CBD >8 mm) and the normal CBD group (diameter of CBD ≤8 mm). The following factors, including operating time, intraoperative bleeding, postoperative hospitalization stay, abdominal drainage tube indwelling time and postoperative complications were compared.Results:The dilated CBD group consisted of 76 patients, with 25 males and 51 females, and a median age of 62.5 years. The normal CBD group consisted of 44 patients, with 19 males and 25 females, and a median age of 57.5 years. There were no significant differences in gender, age, albumin level, total bilirubin and other baseline data between groups ( P>0.05). The operation times of the two groups were the normal CBD group [106.6(87.3, 146.3] min vs the dilated CBD group [112.0(90.5, 134.5)] min; intraoperative blood loss [the normal CBD group 20(10, 30)ml vs dilated CBD group 20(10, 20)ml]; postoperative hospital stay [the normal CBD group 7.0 (5.3, 9.0) d vs the dilated CBD group 7.0 (5.0, 7.0) d]; and postoperative abdominal drainage tube removal time [the normal CBD group 6 (4, 7) d vs the dilated CBD group 5 (4, 6)d]. The differences were all not significant ( P>0.05). There was also no significant difference in the incidences of postoperative complications (including bile leakage, biliary stricture, and stone recurrence between groups, all P>0.05). Conclusion:In patients with a normal diameter (≤8 mm) common bile duct, it was safe and efficacious to perform primary closure after laparoscopic common bile duct exploration.