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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 3
Mar.  2018
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Article Contents

Clinical effect of primary duct closure in laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration among patients with gallstones complicated by common bile duct stones

DOI: 10.3969/j.issn.1001-5256.2018.03.015
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  • Published Date: 2018-03-20
  • Objective To investigate the clinical effect and safety of primary duct closure ( PDC) in laparoscopic cholecystectomy ( LC) combined with laparoscopic common bile duct exploration ( LCBDE) . Methods A retrospective analysis was performed for 76 patients with gallstones complicated by common bile duct stones who were admitted to Department of Hepatobiliary and Pancreatic Surgery in The First Affiliated Hospital of Hainan Medical University from July 2015 to July 2017, and among these patients, 20 underwent LC + LCBDE + PDC ( PDC group) and 56 underwent LC + LCBDE + T-tube drainage ( TTD) ( TTD group) . The two groups were observed and compared in terms of time of operation, intraoperative blood loss, time to gastrointestinal functional recovery after surgery, time to extraction of abdominal drainage tube, length of postoperative hospital stay, and incidence rates of related complications ( residual common bile duct stones, biliary fistula, and biliary tract infection) . The patients were followed up for 2-12 months after surgery. The t-test was used for comparison of continuous data between groups; the chi-square test was used for comparison of categorical data between groups. Results All patients underwent a successful laparoscopic surgery, and no patient was converted to open surgery. There were significant differences between the PDC group and the TTD group in time of operation ( 106. 2 ± 15. 8 min vs 147. 5 ± 23. 2 min, t =-2. 87, P = 0. 036) , time to gastrointestinal functional recovery after surgery ( 32. 9 ± 8. 1 h vs 49. 4 ± 6. 5 h, t =-3. 61, P = 0. 021) , time to extraction of abdominal drainage tube ( 3. 5 ±1. 3 d vs 5. 7 ±2. 6 d, t =-2. 64, P =0. 034) , and length of postoperative hospital stay ( 6. 3 ±1. 5 d vs 11. 4 ±2. 0 d, t =-26. 34, P < 0. 001) . There were no significant differences between the two groups in intraoperative blood loss, postoperative biliary fistula, residual bile duct stones, and biliary tract infection ( all P > 0. 05) . Conclusion A preliminary study of limited cases in our hospital shows that if patients are suitable, PDC is safe and effective in LC and LCBDE.

     

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