Morbidity Of Primary Closure of CBD Versus T-Tube Drainage After Laparoscopic Common Bile Duct Exploration

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Background: Laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) offer one-stage treatment for choledocholithiasis. However, closure of the common bile duct (CBD) either by primary closure (PC) or T-tube drainage (TD) is associated with a higher bile leakage rate. This study aimed to compare the morbidity of primary duct closure with T-tube drainage after LCBDE for choledocholithiasis Methods: This prospective and comparative study was carried out in the surgical department of Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, from 01-01-23 to 31-01-25. 40 patients were equally divided into groups A and B by simple random sampling. After LCBDE, primary closure of the common bile duct in Group A and T-tube drainage in Group B was performed. Data was analysed using SPSS Statistics version 27. The Pearson chi-square test was used for the categorical variables. Whereas continuous variables were analysed with an independent t-test. Results were considered significant when the p-value was ≤ 0.05. Results: Group A had a shorter operating time (97.65 ± 6.5 vs. 103.35 ± 14.35, p-value 0.411), less intra-abdominal blood loss (97.65 ± 6.5 vs. 103.35 ± 14.35, p-value 0.105), a lower complication rate (15% vs. 25%, p-value 0.346), and a significantly shorter postoperative stay (4.60 ± 0.820 vs. 6.30 ± 3.04, p-value 0.021) as compared to the T-tube drainage group. Conclusion: Morbidity of primary closure of CBD after laparoscopic exploration of the CBD was lower than T-tube drainage. Primary duct closure can be safely performed after LCBDE in patients with choledocholithiasis.

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