Effect of laparoscopic C tube drainage combining with primary suture of common bile duct on patients with extrahepatic cholangiolithiasis

Objective To investigate the safty and effect of laparoscopic C tube drainage combining with primary common bile duct suture in the treatment of extrahepatic cholangiolithiasis. Methods Clinical data of 41 patients with extrahepatic cholangiolithiasis admitted in Department of Hepatobiliary Surgery of the Third Affiliated Hospital of Sun Yat-sen University, Department of General Surgery of Lingnan Hospital of the Third Affiliated Hospital of Sun Yat-sen University, and Department of Surgery, Asakayama Hospital of Japan from September 2012 to January 2013 were retrospectively studied. The informed consents of all patients were obtained and the ethical committee approval was received. The patients were divided into two groups: the C tube drainage group (19 cases) and the T tube drainage group (22 cases). There were 11 males and 8 females in the C tube drainage group with age ranging from 30 to 81 years old and the median age of 51 years old, who received laparoscopic cholecystectomy, common bile duct exploration and C tube drainage. There were 10 males and 12 females with age ranging from 25 to 76 years old and the median age of 48 years old in the T tube drainage group, who received laparoscopic cholecystectomy, common bile duct exploration and T tube drainage. The intraoperative bleeding, surgical duration, postoperative length of hospital stay and curative period between two groups were compared by t test. The incidence of bile leakage were compared by Fisher definite probability test. Results All the operations were successful without conversion to laparotomy. There were no significant differences in the intraoperative bleeding [(47±30)ml vs. (55±30)ml], the surgical duration [(123±7)min vs. (127±8)min] between two groups (t=0.86,1.75; P>0.05). No residual extrahepatic cholangiolithiasis was observed in two groups. Bile leakage was observed in one case respectively in each group and the patients were cured by percutaneous peritoneal drainage and conservative treatment. No significant difference was observed in the incidence of bile leakage between two groups(P>0.05). The postoperative length of hospital stay of C tube drainage group and T tube drainage group were (4.8±1.0)d, (9.1±2.4)d respectively, and the curative period were (4.8±1.0)d and (15.6±2.5)d respectively. The postoperative length of hospital stay and curative period in C tube drainage group were evidently shorter than those in T tube drainage group. There were significant differences between two groups (t=7.31,17.71; P<0.05). Conclusions Laparoscopic C tube drainage combining with primary suture of common bile duct is safe and effective in treating patients with extrahepatic cholangiolithiasis, and can evidently shorten the postoperative length of hospital stay and curative period of the patients. Key words: Cholelithiasis; Cholecystolithiasis; Choledocholithiasis; C tube drainage; T tube drainage; Primary suture; Common bile duct; Cholecystectomy, laparoscopic