How to close open choledochotomy: primary closure, primary closurewith T-tube drainage, or choledochoduodenostomy?

Authors: BÜLENT AYDINLI, GÜRKAN ÖZTÜRK, SABRİ SELÇUK ATAMANALP, BÜNYAMİ ÖZOĞUL, ŞÜKRÜ ARSLAN, ERCAN KORKUT, ABDULLAH KISAOĞLU, ABDULMECİT KANTARCI, RÜSTEM BERHAN PİRİMOĞLU, MEHMET İLHAN YILDIRGAN, NURHAK AKSUNGUR

Abstract: Background/aim: Although common bile duct stones are generally treated endoscopically, surgery is required if endoscopic removal is impossible. The aim of this study was to compare the surgical options in such patients. Materials and methods: A total of 282 patients with common bile duct stones underwent open choledochotomy; primary closure was applied in 48 (17.0%), primary closure with T-tube drainage in 81 (28.7%), and choledochoduodenostomy in 153 (54.3%) patients. Results: Postoperative complications were seen in 8 (16.7%) patients in the primary closure, 33 (40.7%) patients in the primary closure with T-drainage, and 37 (24.2%) patients in the choledochoduodenostomy group. No significant differences were observed among the groups (P > 0.05). The mean postoperative hospital stays in the primary closure, primary closure with T-tube drainage, and choledochoduodenostomy groups were 5.5, 13.5, and 8.9 days, respectively. The mean postoperative hospitalization was significantly shorter in the primary closure group than in the other groups (P < 0.05). Conclusion: Primary closure is a safe and feasible method in selected patients.

Keywords: Primary closure, T-tube drainage, choledochoduodenostomy, endoscopic retrograde cholangiopancreatography

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