Primary closure of the common bile duct following exploration has been safely and effectively performed, as advocated by Halsted, provided no evidence of pancreatitis, cholangitis, or ampullary obstruction exists. This study was to gain back confidence to primary closure in selected cases. This study was conducted at Beniswaif University Hospital. Between July 2008 to May. 2014. Using this precedent, the operative management and post-operative course of 19 patients undergoing common bile duct (CBD) exploration for choledocholithiasis were studied, twelve had primary closure of the common bile duct following choledochotomy and exploration, and seven had T-tube placement.
Patients were selected for T-tube if there were pancreatitis, cholangitis, undue trauma, ampullary obstruction. Two patients in that study had bile leak, one in each group. Intravenous fluids were less in primary suture (P<0.001). The long of stay were significantly less in primary suture (P<0.001). The outcome of this study greatly support the safety of primary common bile duct closure in selected cases.
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