Feasibility of the primary suture for the laparoscopic common bile duct exploration with two monitors
Objective To explore the safety and feasibility of the primary suture for the laparoscopic common bile duct exploration(LCBDE)with two monitors.Methods Clinical data of 176 patients treated with LCBDE with two monitors from May 2019 to May 2022 were retrospectively analyzed.According to different treatments of common bile duct incision after stone removal,patients were assigned into primary suture group(80 cases)and T-tube drainage group(96 cases).Perioperative data of the two groups were observed.Results There were no significant differences in the operation time,intraoperative blood loss,postoperative length of stay,case number of bile leakage,inflammatory indicators and liver function before and after surgery between the two groups(P＞0.05).There were significant differences in postoperative anal exhaust time and postoperative electrolyte imbalance between the primary suture group and the T-tube drainage group(P＜0.05).Postoperative complications included 10 cases of bile leakage in the primary suture group and 6 cases in the T-tube drainage group.All of them disappeared after drainage in the unobstructed area.No abdominal infections,such as biliary peritonitis occurred.Before extubating the drainage tube,effusion in the operation area and abdominal cavity was not found by ultrasonography.Electrolyte disorder occurred in 4 cases of the primary suture group and 16 cases of the T-tube drainage group,all of which returned to normal after correction.Conclusion With a strict surgery indications,LCBDE with two monitors and primary suture is safe and effective on removing stones.It offers clinical superiority and benefits patients.
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