Primary CBD Closure VS T-Tube Drainage as a Treatment Option in CBD Exploration

Jan Mohammad Rather; Sobia Manzoor; Mubashir A Shah; Vishal Jaryal

doi:10.33883/jms.v25i1.1148

Jan Mohammad Rather DEPT OF GENERAL AND MINIMAL INVASIVE SURGERY MOGA MEDICITY HOSPITAL, PUNJAB
Sobia Manzoor Department of Anesthesia, Got. Medical College , Srinagar
Mubashir A Shah Department of General Surgery, SKIMS
Vishal Jaryal DEPT OF GENERAL AND MINIMAL INVASIVE SURGERY, MOGA MEDICITY HOSPITAL

DOI: https://doi.org/10.33883/jms.v25i1.1148

Keywords: T-tube, Choledochotomy, bile duct

Abstract

Backgrounds/Aims: Common bile duct (CBD) exploration is necessary to remove stones which are not removable by ERCP. In the concern of potential bile leakage after procedure T- tube is placed. But T-tube itself is known to cause morbidity and thus, prolonged discomfort and care after operation. Also, in laparoscopy, T-tube insertion increases operation time and is technically difficult to place during the procedure.

Methods: Cases of open cholecystectomy and primary closure of CBD not leaving T-tube (n=30, group A) were compared with cases with T-tube placement performed at the same center (n=30, group B) from Jan 2020 to Dec 2021 .Biochemistry, ultrasound and CT scan were followed up for both groups and surveyed on operative complications as well to determine the outcomes.

Results: Bile leakage seen in 1, recurrent stone in 2 and obstructive jaundice in 1 during the follow up period among 30 group A patients (n=6), when compared to T-tube inserted group B patients with 2 cases of bile peritonitis, 1 residual stones and 1 pancreatitis (n=4), showing no significant differences (p=0.08).

Conclusions: CBD exploration and primary cbd closure without T-tube is an acceptable operational option as reported in multiple recent studies.

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Author Biographies

Jan Mohammad Rather, DEPT OF GENERAL AND MINIMAL INVASIVE SURGERY MOGA MEDICITY HOSPITAL, PUNJAB

CONSULTANT

Mubashir A Shah, Department of General Surgery, SKIMS

Additional Professor

Vishal Jaryal, DEPT OF GENERAL AND MINIMAL INVASIVE SURGERY, MOGA MEDICITY HOSPITAL

Senior Resident

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