29. An Experience of Primary Common Bile Duct Closure after Open Choledochotomy as Compared to T-Tube Closure
M. Sharif Awan1, Masood Ahmed Qureshi1, Aijaz Hussain Awan2 and Mushtaque
Ahmed Abbassi1
ABSTRACT
Objective: To evaluate the short and long term benefits and harms of the primary closure without and with T-tube drainage after open choledochotomy.
Study Design: Prospective, comparative randomized control study
Place and Duration of Study: This study was conducted at the Surgical Unit III of Peoples University of Medical and Health Sciences for women and Jinnah Medical Center Nawabshah from June 2013 to July 2017..
Materials and Methods: Seventy patients were randomly selected for the study, 32 underwent primary common bile duct closure (Group A) and in others T-Tube (Group B)was placed. Patients demographic, intraoperative findings, postoperative stay, complications and long term follow-up data were recorded and compared.
Results: Seventy patients were randomly selected in the study. The age range of patients was 22 to 75 years. In primary closure group A(n =32) four (12.5%) males and 28 (87.5%) females. In 2 patient (6.3%) bile leakage noted which subsided without any biliary peritonitis, as compared to the T-tube group B (n=38) six male and 32 females, five patients (13.5%) resulted bile leakage. No one patient had a retained stone in both groups and no jaundicein groupAbut postoperative jaundice was seen in two patients (5.3%) group B because of CBD blockage. The postoperative hospital stay in group A was 4.5±1.2 days and in B was 12.5±1.5 days. The total cost of treatment in group B was Rs/60000 ± 12000± (US≠ 500± 100) and group A was Rs/35000±5000 (USD 200±50). Follow up time was six months.
Conclusion: The primary closure might be much effective and safe as compared to T-tube drainage after open choledocotomy and less postoperative complications.
Key Words: open choledochotomy, choledocholithiasis, primary closure, T-tube drainage
Citation of articles: Awan MS, Qureshi MA, Awan AH, Abbassi MA. An Experience of Primary Common Bile Duct Closure after Open Choledochotomy as Compared to T-Tube Closure. Med Forum 2018;29(10):117-121.