Primary Closure of the Duct Following Common Bile Duct Exploration in Choledocholithiasis -A Comparison between T-tube Drainage and RTBD-tube Drainage-

Toshiomi Kusano, Norihiko Okushima, Masahito Yamazato, Shigeru Deguchi, Satoshi Tamaki, Masafumi Nohara, Kaneatsu Honma, Fumio Tokumine, Yoshihiro Muto, Masato Fukukawa*

The First Department of Surgery, University of Medicine, School of the Ryukyus
*Department of Surgery, Nagasaki Chuo National Hospital

Retrograde transheptic biliary drainage (RTBD) and primary closure of the common bile duct (CBD), as a new method of treatment for choledocholithiasis, was compared retrospectively to conventional T-tube drainage as a control, in terms of postoperative major complications which necessitate laparotomy. We also evaluated radiographic diametric change in CBD at the site of primary closure and changes in liver function tests after this procedure. Between April 1986 and July 1991, a total 132 cases were managed by this procedure and compared with 199 cases of conventional T-tube drainage. In the RTBD group, only one (0.8%) postoperative major complication was seen due to incomplete fistula formation, while eight (4%) major complications were seen in the control group. Cholangiography via the RTBD tube revealed no severe stenosis at the site of primary closure. Liver function tests returned to normal levels immediately after the RTBD procedure. From these data we conclude that RTBD and primary closure of the CBD may be a clinically safe, alternative procedure for choledocholithiasis.

Key words
primary closure of the duct, retrograde transhepatic biliary drainage, T-tube drainage, choledocholithiasis

Reprint requests
Toshiomi Kusano The First Department of Surgery, School of Medicine, University of the Ryukyus
207 Uehara, Nishihara Cho, Okinawa, 903-01 JAPAN

Accepted
April 14, 1993

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