Comparison of primary repair versus T-tube placement after CBD exploration in the management of choledocholithiasis

Background: choledocholithiasis is the formation of gallstones in the common bile duct. these stones are removed by performing common bile duct exploration. the choice lies between primary duct closure and t-tube drainage which is a standard practice after surgical choledochotomy. aim: to determine the safety and efficacy profile of primary repair versus t-tube placement in the management of choledocholithiasis. methods: this was a randomized trial. this study was carried out in department of surgery,lahore general hospital,lahore. total 40 patients were included in the study and randomly classified into two groups. in group-a patients were treated with cbd exploration and primary closure,and in group-b patients were treated with cbd exploration and primary closure with t-tube. results: the mean age of patients in group-a was 41.85±9.33 years and in group-b 40.35±11.09 years. the mean operative time,post operative hospital stay and time for sub hepatic drain values were significantly short (p-value < 0.05) in group-a as compared to corresponding values of group-b. conclusion: primary repair is more effective and safe in comparison to t-tube placement for treating choledocholithiasis in terms of leakage/biliary peritonitis,time for subhepatic drain removal after surgery,operative time and post operative hospital stay. all these outcome parameters are of clinical significance for primary closure.