Comparison of T-Tube Placement Vs Primary Repair of Common Bille Duct in Choledochotomy

Abstract

Objective: To compare the outcome of T-tube placement vs primary repair of the common bile duct in cases of CBD exploration using choledochoscope in a tertiary care hospital.

Study Design: Randomized controlled trial.

Place and Duration of the Study: Department of Surgery, SGTH Saidu Medical College, Saidu Sharif Swat KP – Pakistan from January-2024 to July-2024.

Methodology: In this randomized clinical trial, we included 100 Cases of choledocholithiasis undergoing choledochotomy. The patients were recruited from January-2024 to July-2024. In first group (P), CBD exploration was done using primary repair. In second group (T), CBD exploration was done using T-tube placement. Operative time, bile leakage, wound infections and hospital stay were compared between the two groups.

Results: Mean age of study patients was 42.66±9.27 years in group P and 43.9±6.79 years in group T (p-value 0.42). Mean operative time was prolonged in group T; 88.5±6.22 minutes versus 76.6±9.17 minutes in group P (p-value <0.0001). Bile leak occurred in 2 (4.0%) patients in group P and in 8 (16%) in group T (p-value 0.04). Wound infections occurred in 3 (6%) in group P and in 9 (18%) patients in group T (p-value 0.06). Mean hospital stay was also prolonged in group T; 12.7±4.46 days versus 8.24±2.59 days in group P (p-value <0.0001).

Conclusion: Primary repair of CBD is associated with shorter operative time and hospital stay in comparison to T-tube placement in patients undergoing choledochotomy.