Primary common bile duct closure on a choledocho duodenal stent

ABSTRACT

In this study 49 patients had exploration of common bile duct [CBD]. They undergo primary closure after insertion of choledocho duodenal stent. Our purpose is to evaluate the efficiency of this method, with special attention to post operative complication and stent expulsion. Fourty seven patients with stones CBD and two with iatrogenic injury of their CBD during cholecystectomy, were included in this work. Duct clearance was insured proximally and distally. Nelaton tube 8-10 Fr. was inserted into the CBD down to the duodenum. Choledochotomy incision was closed primarily using polyglycolic acid stutre. Single suction drain inserted subhepatic near the suture line. Patients with stenosed lower end of CBD and sphincter of Oddi were excluded. No operative mortality. mean hospital stay was 4.4 days, one patient stayed for 18 days as he developed pancreatitis Another patient remain in the hospital for 10 days due to chest infection. The stent passed with defaecation spontaneously at 25 - 40 days. No other complication developed during 24 months follow up. Closure of CBD primarily with an internal drainage using choledocho duodenal stent is a safe and effective procedure. It requires a short hospital stay compared with T- tube drainage, many patients return to work within 2 weeks