Primary Closure versus T-Tube Drainage after Laparoscopic Choledochotomy in Patients with Common Bile Duct Stones

AIM: To demonstrate safety and feasibility of primary closure of common bile duct after laparoscopic choledochotomy and removal of CBD stones. Traditionally CBD is closed with T-tube drainage after choledochotomy and removal of CBD stones, still this method is in practice, but now a days primary closure after stent placement is more commonly used technique. Many of the trials has been conducted to compare the outcomes for both types of drainage techniques. In the laparoscopic era surgery is performed with minimally invasive techniques in order to reduce trauma, T-tube is not without complications and patient have to carry it for several weeks before removal, So we believe that primary closure can be safe as closure with T tube drainage. METHODOLOGY: This is Retrospective analysis of patient who underwent Primary closure of CBD after successful laparoscopic choledochotomy for ductal stones between June 2018 and December 2019 RESULT: Of the 28 patients that underwent laparoscopic exploration of CBD 3 patients undergo transcystic duct approach and 25 underwent choledochotomy and 7 cases converted to open CBD exploration. Stone clearance was achieved in all patients with successful laparoscopic choledochotomy. Of the 18 patients who could successfully operated as laparoscopic choledochotomy 11 had primary closure& 7 had T tube drainage, the median operative time was less in primary closure postoperative stay is shorter in primary closure. CONCLUSION: Primary closure of CBD is feasible and safe as T-tube insertion after laparoscopic choledochotomy for stone disease.