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PubMed · 15457567

Biliary drainage after laparoscopic choledochotomy.

Qi Wei·Hong-Jie Hu·Xiao-Yan Cai·Li-Bo Li·Guan-Yu Wang
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Abstract

AIM: Transcystic biliary decompression (TCBD) has been proposed as an alternative to T-tube placement after laparoscopic choledochotomy (LCD). This permits safe primary closure of the choledochotomy and eliminates the complications associated with T-tubes. TCBD tube has been secured by Roeder knots and transfixation, and removed later than 3 wk after surgery. We presented a modified TCBD (mTCBD) method after LCD using the ureteral catheter and the Lapro-Clip (David and Geck, Danbury, Connecticut, USA), and compared it with T-tube drainage. METHODS: Between October 2002 and June 2003, patients with choledocholithiasis undergoing LCD with mTCBD (mTCBD Group, n = 30) were retrospectively compared to those undergoing LCD with T-tube drainage (T-tube Group, n = 52) at a single institution. RESULTS: There were no significant differences in operative time and retained stones between the two groups. Patients in mTCBD group had a significantly decreased average output of bile compared with those in T-tube group (306+/-141 vs 409+/-243 mL/24 h, P = 0.000). Removal of drain tubes in mTCBD group was done significantly earlier than that in T-tube group (median, 5 vs 29 d, P = 0.000). No complication related to drain tubes was found in mTCBD group, and morbidity rate with the T-tube was significantly higher (11.5%), and bile leakage following T-tube removal was 5.8%. CONCLUSION: A modified TCBD after LCD is safe, effective and easy to perform. It may reduce postoperative complications, especially bile leakage.

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AdultAgedAged, 80 and overBileCholedocholithiasisCholedochostomyDecompression, SurgicalDrainageFemaleHumansLaparoscopyMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTreatment OutcomeComparative StudyJournal Article

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Qi Wei, Hong-Jie Hu, Xiao-Yan Cai, Li-Bo Li, Guan-Yu Wang. 2004-11-01. Biliary drainage after laparoscopic choledochotomy.. https://doi.org/10.3748/wjg.v10.i21.3175

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