Is an 8 mm cutoff necessary when performing primary common bile duct closure after laparoscopic common bile duct exploration?

腹腔镜胆总管探查术后行胆总管原位缝合时,是否需要截断 8 毫米?

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Abstract

OBJECTIVE: To evaluate whether the efficacy and safety of primary duct closure(PDC) was limited to patients with a wider common bile duct(CBD) (≥8 mm). METHODS: A retrospective study of patients who underwent PDC after laparoscopic common bile duct exploration (LCBDE) at Taicang Affiliated Hospital of Soochow University from March 2012 to June 2019 was performed. Fifty-five patients were enrolled and classified into two groups according to the diameter of the CBD: the wider group (Group-W, CBD diameter≥8 mm, n=36) and the slender group (Group-S, CBD diameter<8 mm, n=19). The clinical data were compared and analysed. RESULTS: No significant difference in the mean operative time, mean hospital stay or mean total charge was observed. Bile leakage occurred in 5.26%(1/19) of patients in Group-S, which accounted for only 1.81% (1/55) of total patients. There were no severe complications or mortality in either group. No significant differences in the rate of stone recurrence were observed. No biliary stricture occurred during follow-up. CONCLUSIONS: PDC may not be limited by the slender CBD (<8 mm), and the proper selection of patients and the standard surgical procedure are particularly important.

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