Abstract :
Aim: a prospective study to compare different techniques in closing common bile duct after choledocho-lithotomy as T-tube drainage, intra-operative stenting, and primary closure with sphincterotomy as regard indications, operative time, hospital stay, complications, returns to work, coast, and feasibility. Methods: From April 2005 to May 2006, 52 patients suffering from common bile duct (CBD) stone were selected, and operated upon for choledocho-lithotomy then randomized into group A included 19 cases were subjected to T-tube drainage, group B included 18 cases were subjected to intra-operative stenting, and group C included 15 cases were subjected to primary closure and sphincterotomy, patients were followed up for a period of 6-9 months post-operatively for evaluation. Results: The three methods are effective and safe however, the hospital stay was reduced, the patients were more comfortable and rapidly return to work with CBD stents and primary closure compared to T-tube drainage, consequently the coast was reduced, however operative time was not significantly different, and also the complications was comparable. Conclusion: Intra-operative stenting of CBD and primary closure with sphincterotomy are effective, safe optional techniques after choledocho-lithotomy with better patient compliance, shorter hospital stay, and costly effective, and should be considered whenever feasible
