Laparoscopic Common Bile Duct T-tube Drainage:Prospective Study Of Three T-tube Suture Techniques

BackgroundCholelithiasis usually requires indwelling a T-tube for drainage after stone removal.However,placing and suturing T-tubes under laparoscopy is very difficult.After effective stone removal during surgery,there are various suture methods for retaining the T-tube in the common bile duct.At present,research has shown that using barbed sutures can reduce the difficulty of suturing,but there is currently no clear study on the suturing method.It is worth studying how to simplify and effectively place and suture T-tubes under laparoscopy to avoid postoperative biliary fistula.This study compared the effectiveness and safety of three suture techniques for T-tubes using barbed wire.MethodsWe prospectively included 90 patients(males:43;females:47)who underwent laparoscopic common bile duct T-tube drainage at the affiliated hospital from March 2021 to April 2022.Using computerized randomization,the patients were split into three groups of 30:unilateral continuous suture group(group A),continuous suture around T-tube group(group B),intermittent suture on one side and continuous suture on the other side(Group C).The effectiveness and safety of the groups were evaluated by comparing the suture time,intraoperative bleeding,postoperative biliary fistula and other conditions of the three groups.ResultsAll 90 patients successfully completed laparoscopic T-tube drainage of the common bile duct without the need to switch to open surgery.The average suturing time of Group A,Group B,and Group C were 9.72±2.27 minutes,11.44±3.61 minutes,and 12.33±3.86 minutes,respectively.Statistical analysis showed that the T-tube suture time in Group A was significantly shorter than that in Group B and Group C(P<0.05).The incidence of postoperative biliary fistula in Group A was lower than that in Group B,and there was no statistically significant difference compared to Group C.There was no statistically significant difference in surgical time,discharge time,intraoperative bleeding,and postoperative T-tube removal time among each group.ConclusionsUnilateral reverse stitching of the T-shaped common bile duct is safe and reliable.It provides good stitching effect.Therefore,in T-tube drainage and bile duct exploration,it can be the preferred method for suture of the common bile duct.