• Nadia Saeed
  • Muhammad Tauqeer Nasir
  • Muhammad Iqbal Khan
  • Ghulam Asghar Channa


Background: T-tube drainage used to be standard practice after surgical choledochotomy, but there isnow a tendency in some canters to close the common bile duct primarily. This study was designed tocompare the clinical results of primary closure with T-tube drainage after open choledocotomy andassess the safety of primary closure for future application. Methods: This study was conducted atsurgical Unit-3, ward 26 Jinnah Postgraduate Medical Centre Karachi, from January 2007 to January2008. Forty patients were included in this study out of which 20 underwent primary closure and 20 Ttube placements. It was Quasi-experimental, non-probability, purposive sampling. Main outcomemeasures were operating time, duration of hospital stay, and postoperative complications. SPSS-10 wasused for data analysis. Results: The age of patients in the study ranged from 29–83 years. There were 3male while 37 female patients. Group-1 consisted of 20 patients underwent primary closure aftercholedocotomy, while Group-2 also consisted of 20 patients underwent T-tube drainage after ductexploration. Mean hospital stay in Group-1 patients was 7.63 days while in group 2 it was 13.6 days.Overall complication rate in group 1 was 15%, biliary leakage in 1 (5%), jaundice in 1 (5%), woundinfection in 1 (5%). No re-exploration was required in Group-1. In Group-2 overall complication ratewas 30%, biliary leakage in 2 (2%), jaundice in 1 (5%), dislodgement of T-tube in 1 (5%), woundinfection in 1 (5%), and sepsis in 1 (5%) patients. Re-exploration was done in one patient. Conclusion:Primary closure of Common Bile Duct (CBD) is a safe and cost-effective alternative procedure toroutine T-tube drainage after open choledocotomy.Keywords: Open choledocotomy, Primary closure, choledocholithiasis


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