Choledochorraphy (primary repair) versus t-tube drainage after open choledochotomy.

T-tube drainage used to be standard practice after surgical choledochotomy,but there is now a tendency in some canters to close the common bile duct primarily. this study was designed to compare the clinical results of primary closure with t-tube drainage after open choledocotomy and assess the safety of primary closure for future application. this study was conducted at surgical unit-3,ward 26 jinnah postgraduate medical centre karachi,from january 2007 to january 2008. forty patients were included in this study out of which 20 underwent primary closure and 20 t-tube placements. it was quasi-experimental,non-probability,purposive sampling. main outcome measures were operating time,duration of hospital stay,and postoperative complications. spss-10 was used for data analysis. the age of patients in the study ranged from 29-83 years. there were 3 male while 37 female patients. group-1 consisted of 20 patients underwent primary closure after choledocotomy,while group-2 also consisted of 20 patients underwent t-tube drainage after duct exploration. 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%),wound infection in 1 (5%). no re-exploration was required in group-1. in group-2 overall complication rate was 30%,biliary leakage in 2 (2%),jaundice in 1 (5%),dislodgement of t-tube in 1 (5%),wound infection in 1 (5%),and sepsis in 1 (5%) patients. re-exploration was done in one patient. primary closure of common bile duct (cbd) is a safe and cost-effective alternative procedure to routine t-tube drainage after open choledocotomy.