Study of Primary Closure of the Common Bile Duct for Choledocholithiasis

Ken Seshimo, Shigeo Kagawa, Akihiko Tatemoto, Yasutaka Kokudo, Atsushi Muraoka, Yoshiyuki Sone, Makoto Tsumura and Masaki Tsuruno

Department of Surgery, Kagawa Rousai Hospital

One hundred twenty-one cases were diagnosed as choledocholithiasis at Kagawa Rousai Hospital between Sep. 1991 and Mar. 1998. Thirty-eight patients undergoing primary closure (primary closure group) and eighty patients undergoing T-tube drainage (T-tube group) were compared clinically to evaluate the effectiveness of primary closure of the common bile duct for choledocholithiasis and associated problems. The incidence of postoperative bile leakage in the primary closure group was 14.3%. The incidence of localized peritonitis after removal of the T-tube because of incomplete fistula formation in the T-tube group was 5.0%. Postoperative liver dysfunction was noted in 5.3% in the primary closure group and in 5.0% in the T-tube group. The duration of postoperative hospital stay was 18.5 days in the primary closure group, and significantly shorter than the 36.0 days in the T-tube group. The primary closure group had fewer complications. Shortening the duration of postoperative hospital stay and the same outcome as in the T-tube group were obtained in the primary closure group. We concluded that primary closure of the common bile duct for choledocholithiasis is more effective than the T-tube drainage.

Key words
primary closure, T-tube drainage, choledocholithiasis

Reprint requests
Ken Seshimo Department of Surgery, Watanabe Gastroenterological Hospital 539-5 Tamashima Uwanari, Kurashiki, 713-8101 JAPAN

Accepted
June 28, 2000

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