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| Médium: | Recurso digital |
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Zenodo
2026
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| On-line přístup: | https://doi.org/10.5281/zenodo.19701952 |
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- <p class="MsoNormal"><strong><span>Objective:</span></strong><span><br>To compare postoperative outcomes of laparoscopic primary closure of the common bile duct (CBD) versus T-tube drainage following laparoscopic choledochotomy for choledocholithiasis.</span></p> <p class="MsoNormal"><strong><span>Study Design:</span></strong><span><br>Prospective cohort study.</span></p> <p class="MsoNormal"><strong><span>Place and Duration of Study:</span></strong><span><br>Department of General Surgery, Nishtar Hospital Multan, conducted over a period of six months after approval from the Institutional Ethical Review Board.</span></p> <p class="MsoNormal"><strong><span>Methodology:</span></strong><span><br>A total of 228 patients aged 30–60 years diagnosed with choledocholithiasis were enrolled using non-probability consecutive sampling. Patients were allocated into two equal groups of 114 each based on intraoperative decision of the consultant surgeon. Group A underwent laparoscopic choledochotomy followed by primary closure of the CBD using interrupted 3-0 Vicryl sutures. Group B underwent laparoscopic choledochotomy with placement of a 12/14 French T-tube. Postoperative outcomes assessed included hospital stay, bile leakage, and surgical site infection. Patients were followed for three months. Data were analyzed using SPSS version 26. Independent sample t-test was applied for comparison of continuous variables, and Chi-square/Fisher’s exact test was used for categorical variables. A p-value ≤ 0.05 was considered statistically significant.</span></p> <p class="MsoNormal"><strong><span>Results:</span></strong><span><br>The mean hospital stay was significantly shorter in the primary closure group (6.3 ± 1.7 days) compared to the T-tube group (9.5 ± 2.2 days) (p < 0.001). Bile leakage occurred in 6.1% of patients in the primary closure group and 7.9% in the T-tube group (p = 0.61). Surgical site infection was observed in 4.4% of patients in Group A and 7.0% in Group B (p = 0.38). No statistically significant differences were observed in operative time or major postoperative complications between the two groups.</span></p> <p class="MsoNormal"><strong><span>Conclusion:</span></strong><span><br>Laparoscopic primary closure of the common bile duct following choledochotomy is a safe and effective alternative to T-tube drainage. It significantly reduces hospital stay without increasing postoperative complications. Primary closure should be considered the preferred approach in appropriately selected patients.</span></p>