| CLINICAL EXPERIENCE
 Primary Closure of the Common Bile Duct and Double-Pigtail ERBD Tube in a Choledocholithiasis 
Masakazu Fujii, Motonori Okino, Kentaro Fujioka and Katsuyuki Yamashita 
Department of Surgery, Onoda City Hospital 
An 88-year-old woman admitted for fever and vomiting was diagnosed with cholecystitis and choledocholithiasis. Choledocholithotomy was conducted, and the common bile duct closed, including placement of a double-pigtail endoscopic retrograde biliary drainage (ERBD) tube. The ERBD tube was removed endoscopically on postoperative day (POD) 29. It is thought that patients with senile dementia may pull out T and C-tubes, resulting in biliary peritonitis. Complications are more frequent in patients undergoing primary closure of the common bile duct alone than in patients in whom T-tube drainage is used. We conclude that primary closure of the common bile duct with placement of a double-pigtail ERBD tube is clinically safe for choledocholithiasis patients with senile dementia; complications should be infrequent. 
Key words 
primary closure of common bile duct, double-pigtail ERBD tube, bile drainage 
Jpn J Gastroenterol Surg 37: 252-256, 2004 
 
Reprint requests 
Masakazu Fujii Department of Surgery, Onoda City Hospital 
1863-1 Higashitakatomari, Onoda-shi, 756-0094 JAPAN 
Accepted 
September 24, 2003 
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