PRIMARY CLOSURE OF COMMON BILE DUCT AFTER STONE EXTRACTION FROM CBD IN OPEN LAPOROTOMY IN REMOTE AREA.

Dr Dusmanta Barman, Dr Arijit Mukherjee

Abstract


Primary closure of common bile duct is a safe procedure following common bile duct exploration without T-tube drainage. Aim of this study is to investigate long-term results of primary choledochorrhaphy. T tube drainage following CBD exploration has been a gold standard for a long time now. This has its own problems, mainly prolonging hospital stay and leakage around T-tube. This study was designed to assess the outcome of primary repair of CBD in terms of operating time, duration of hospital stay and postoperative complications(1). Our results indicate that the hospital stay is reduced to half in cases with primary closure and there were no significant complications resulted in primary closure cases. On the basis of the experience of open CBD exploration, T-tube drainage has been widely adopted in the past two decades. However, T-tube drainage has many problems, such as fluid and electrolyte disturbance, sepsis, premature dislodgement, bile leakage, prolonged biliary fistula, late bile duct stricture, and possible peritonitis after removal of the T-tube . These complications and the need of satisfactory follow-up cholangiography prolonged the hospital stay and increased hospital expenses

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