Clinical Consideration of Choledocholithiasis Treatment: Analysis of Primary Closure versus T-tube Drainage after Choledochotomy
Journal of the Korean Surgical Society
; : 55-60, 2003.
Article
Dans Ko
| WPRIM
| ID: wpr-68196
Responsable en Bibliothèque :
WPRO
ABSTRACT
PURPOSE:
The placement of a drainage tube in the common bile duct, following a choledochotomy, has become accepted as routine procedure since it was first reported, by Abbe, in 1892. However, many complications are associated with T-tube drainage, such as bile peritonitis after its removal, accidental dislodgement, bile leakage from the T-tube track and a high incidence of postoperative bacteremia, have been reported. This study was designed to evaluate the primary closure as a suitable surgical technique in placce of T-tube drainage following a choledochotomyMETHODS:
Between January and December 2002, primary closures were performed in 41 cases and T tube drainage in 112, following a choledochotomy. These cases were divided into 2 groups (group A primary closure, and group B T-tube drainage). The medical records of the patients were reviewed, and the following data analysed -age, sex, preoperative laboratory value, intraoperative finding, postoperative laboratory value, complication, and days of postoperative hospital stay.RESULTS:
There were no significant differences observed in the data of the investigated parameters, with the exception of the mean post-operative hospital stay. The mean post- operative hospital stays were 11.82 and 18.08 days in groups A and B (P=0.0034), respectively. The complication rates of each group showed no statistical difference. However bile peritonitis or bile leakage after T-tube removal developed 5 cases from group B. There were 2 and 5 deaths due to MODS & ARDS, respectively.CONCLUSION:
A primary closure, following a choledochotomy, may be a suitable alternative technique to T-tube drainage under reasonable conditions.
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Péritonite
/
Bile
/
Drainage
/
Dossiers médicaux
/
Incidence
/
Bactériémie
/
Conduit cholédoque
/
Lithiase cholédocienne
/
Durée du séjour
/
Défaillance multiviscérale
Type d'étude:
Incidence_studies
/
Prognostic_studies
Limites du sujet:
Humans
langue:
Ko
Texte intégral:
Journal of the Korean Surgical Society
Année:
2003
Type:
Article