Primary Closure Versus Biliary Drainage After Laparoscopic Choledocotomy: Results of a Comparative Study. - Université de Bretagne Occidentale Access content directly
Journal Articles Surgical Laparoscopy Endoscopy & Percutaneous Techniques Year : 2016

Primary Closure Versus Biliary Drainage After Laparoscopic Choledocotomy: Results of a Comparative Study.

Abstract

To evaluate the feasibility, safety, and short-term outcomes of primary closure (PC) and biliary drainage (BD), after the laparoscopic treatment of common bile duct (CBD) stones by choledocotomy.
Between January 2009 and December 2014, 102 patients underwent laparoscopy for lithiasis of the CBD. Intraoperative cholangiography was systematically performed, followed by choledocoscopy, depending on the size of the CBD.
Eighty (78.4%) of the 102 patients underwent laparoscopic stone extraction by choledocotomy, and were assigned to 2 groups: PC (group A, n=25), and BD (group B, n=55). Groups A and B were comparable in terms of age (62.3±26.1 vs. 66.0±19.3 y; P=0.53), the percentage of women (72.0% vs. 76.4%; P=0.68), body mass index (25.9±6.1 vs. 26.9±4.4 kg/m; P=0.52), and CBD diameter (11.6±3.1 vs. 12.1±3.8 mm; P=0.59). The mean durations of surgery and of hospital stay were significantly shorter in group A: 179±38 versus 211±57 minutes (P=0.02) and 5.4±2.0 versus 8.4±3.2 days (P<0.001). Groups A and B were comparable in terms of serious postoperative morbidity (Clavien-Dindo scores of 3, 4, and 5): 2 versus 4 (P=1). In group B, bile drain removal was complicated by choleperitoneum in 3 cases.
With shorter durations of surgery and hospital stay, equivalent postoperative morbi-mortality, and an absence of the specific morbidity due to bile drainage, PC may be considered a safe and feasible option for the laparoscopic management of CBD stones by choledocotomy.

Domains

Surgery
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Dates and versions

hal-01560571 , version 1 (11-07-2017)

Identifiers

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Cyril Audouy, Jérémie Thereaux, Gaby Kansou, Geoffroy Leroux, Bogdan Badic, et al.. Primary Closure Versus Biliary Drainage After Laparoscopic Choledocotomy: Results of a Comparative Study.. Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 2016, 26 (1), pp.e32-6. ⟨10.1097/SLE.0000000000000242⟩. ⟨hal-01560571⟩
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