Efficacy And Safety Of Laparoscopic Choledochal With Primary Closure In Treatment Of Common Bile Duct Stones

[Objective]To investigate the efficacy and safety of primary closure of the common bile duct in treatment of common bile duct stones[Method]One hundred and thirty-eight patients with gallstones and concomitant choledocholithiasis admited in the Department of Hepatobiliary Surgery of Hunan Provincial People's Hospital were enrolled.Of the patients,45 cases underwent laparoscopic cholecystectomy,common bile duct exploration and primary choledochal closure(primary closure group),and 93 cases underwent laparoscopic cholecystectomy and common bile duct exploration plus T-tube drainage(T-tube drainage group).The main clinical variables between the two groups of patients were compared[Results]Operations were successfully completed in all the 138 patients,and no serious surgical complication occurred.In primary closure group compared with T-tube drainage group,the operative time,intraoperative blood loss showed no signifcant difference(all P>0.05),but the operation time?the time to postoperative bowel function recovery,retention of the bile drainage tube,length of hospital stay and hospitalization cost as well as the amount of postoperative fluid infusionwere all signifcantly reduced(all P<0.05).Tere was no signifcant difference in overall incidence of postoperative complications between the two groups(P>0.05),but the incidence of symptoms of electrolyte imbalance such as nausea and vomiting in primary closure group was signifcantly lower than that in the T-tube drainage group(P<0.05)[Conclusion]primary closure of the common bile duct can shorten the tube retention and length of hospital stay,and reduce the fluid and electrolyte disorders,with no increase of complications such as bile leakage and biliary stricture.It has certain superiority to T-tube drainage,but its indications should be followed.