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Primary suture for patients of bile duct stones after laparoscopic biliary tract exploration: a retrospective cohort study

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Abstract

There are still many physicians who are reluctant to use primary biliary suture in Laparoscopic common bile duct exploration (LCBDE) for fear of more complications. We compare and analyze the clinical effectiveness of bile duct primary suture with three laparoscopic ports and indwelling T-tube drainage (with four laparoscopic ports) in patients with choledocholithiasis after LCBDE. Clinical data of 135 patients with common bile duct (CBD) stone were compared, including general conditions, postoperative hospital stay, postoperative complications, hospitalization costs, postoperative follow-up and other indicators. Forty-eight patients underwent primary suture of bile duct (group A) and 87 were treated with external T-tube drainage (group B). There were no significant differences between the two groups neither relating to the age, gender, BMI, diameter of CBD, number of stones, preoperative bilirubin value, number of previous surgeries in preoperative, nor the operation time, residual stones, the number of cases converted from laparoscopic conversion to laparotomy. The postoperative complications like fever, bleeding, incision infection, bile duct stricture has no differences between two group. The incidence of bile leakage (p = 0.008) and postoperative electrolyte disturbance (p = 0.001) were slightly lower in group A. There were fewer postoperative complications in group A vs group B (p = 0.04). Patients in group A experienced shorter postoperative hospital stay (p < 0.001), earlier postoperative extubation (p < 0.001), lower total hospitalization costs (p = 0.03), and earlier postoperative recovery (p = 0.000). Primary suture of CBD is a safe and effective method for some patients after LCBDE.

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The data generated and/or analyzed during this study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of General Surgery, The First Affiliated Hospital of Bengbu Medical College, NO. 287, Changhuai Road, Longzihu District, Bengbu, 233000, Anhui, China

    DengYong Zhang, Yang Ma, Wanliang Sun, Zhong Liu & Zheng Lu

  2. Department of Operating Room, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, Anhui, China

    Ning Wang

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  1. DengYong Zhang
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  2. Yang Ma
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  3. Wanliang Sun
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  4. Ning Wang
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  5. Zhong Liu
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  6. Zheng Lu
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Contributions

Study concept: ZDY and LZ. Data collection: SWL, WN and LZ. First draft and Data analysis: ZDY and MY. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zheng Lu.

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The authors declare that they have no competing interests.

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The patients’ written informed consent for publication were obtained.

Research involving human participants and/or animals and informed consent

This study was conducted in accordance with the principles of the Helsinki Declaration. The study was approved by the Ethics Committee of Bengbu Medical College.

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Zhang, D., Ma, Y., Sun, W. et al. Primary suture for patients of bile duct stones after laparoscopic biliary tract exploration: a retrospective cohort study. Updates Surg 75, 897–903 (2023). https://doi.org/10.1007/s13304-023-01451-5

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  • DOI: https://doi.org/10.1007/s13304-023-01451-5

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