Advantages of laparoscopic stented choledochorrhaphy over T-tube placement
| Autor: | John Griniatsos, Alberto Isla, J. D. Arbuckle, Evangelos Karvounis |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Preoperative care Postoperative Complications medicine Humans Laparoscopy Aged Retrospective Studies Univariate analysis Common bile duct medicine.diagnostic_test business.industry Stent Retrospective cohort study Length of Stay Middle Aged Endoscopy Surgery medicine.anatomical_structure Choledocholithiasis Treatment Outcome Cholecystectomy Laparoscopic Choledochostomy Drainage Cholecystectomy Female Stents business |
| Zdroj: | The British journal of surgery. 91(7) |
| ISSN: | 0007-1323 |
| Popis: | Background Postoperative complications after laparoscopic choledochotomy are mainly related to the T tube. Both laparoscopic endobiliary stent placement with primary closure of the common bile duct (CBD) and primary closure of the CBD without drainage have been proposed as safe and effective alternatives to T-tube placement. Methods This was a retrospective analysis of data collected prospectively on 53 consecutive patients suffering from proven choledocholithiasis who underwent laparoscopic CBD exploration through a choledochotomy between January 1999 and January 2003. In the early period a T-tube was placed at the end of the procedure (n = 32). Biliary stent placement and primary CBD closure was performed from June 2001 (n = 21). Results There were no significant differences in epidemiological characteristics, preoperative factors or intraoperative findings between the groups. Seven patients developed complications, six in the T-tube group and one in the stent group. Univariate analysis revealed a significantly lower morbidity rate and shorter postoperative hospital stay in the stent group. Conclusion Placement of a biliary endoprosthesis after laparoscopic choledochotomy achieves biliary decompression, and avoids the complications of a T tube, leading to a shorter postoperative hospital stay. The method is a safe and effective alternative method of CBD drainage after laparoscopic choledochotomy. |
| Databáze: | OpenAIRE |
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