Use of biliary stent in laparoscopic common bile duct exploration

Lyon, Matthew, Menon, Seema, Jain, Abhiney and Kumar, Harish (2015) Use of biliary stent in laparoscopic common bile duct exploration. Surgical Endoscopy, 29 5: 1094-1098. doi:10.1007/s00464-014-3797-y

Author Lyon, Matthew
Menon, Seema
Jain, Abhiney
Kumar, Harish
Title Use of biliary stent in laparoscopic common bile duct exploration
Journal name Surgical Endoscopy   Check publisher's open access policy
ISSN 0930-2794
Publication date 2015-05
Year available 2014
Sub-type Article (original research)
DOI 10.1007/s00464-014-3797-y
Volume 29
Issue 5
Start page 1094
End page 1098
Total pages 5
Place of publication New York, NY, United States
Publisher Springer New York
Collection year 2016
Language eng
Formatted abstract
Introduction: It is well supported in the literature that laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis has equal efficacy when compared to ERCP followed by laparoscopic cholecystectomy. Decompression after supra-duodenal choledochotomy is common practice as it reduced the risk of bile leaks. We conducted a prospective non-randomized study to compare outcomes and length of stay in patients undergoing biliary stent insertion versus T-tube drainage following LCBDE via choledochotomy.

Methods and procedures: The study involved 116 patients with choledocholithiasis who underwent LCBDE and decompression of the biliary system by either ante-grade biliary stent or T-tube insertion. A 7 French straight/duodenal curve biliary Diagmed™ stent (9–11 cm) was placed in 82 patients (Biliary Stent Group). T-tube insertion was used for 34 patients (T-tube group). The length of hospital stay and complications for the selected patients were recorded. All trans-cystic common bile duct explorations were excluded from the study.

Results: The mean hospital stay for patients who underwent ante-grade biliary stent or T-tube insertion after LBCDE were 1 and 3.4 days, respectively. This is a statistically significant result with a p value of less than 0.001. Of the T-tube group, two patients required laparoscopic washout due to bile leaks, one had ongoing biliary stasis and one reported ongoing pain whilst the T-tube was in situ. A complication rate of 11.2 %, this was a significant finding. There were no complications or concerns reported for the Biliary Stent Group.

Conclusion: Our results show that there is a significant reduction in length of hospital stay and morbidity for patients that have ante-grade biliary stent decompression of the CBD post laparoscopic choledochotomy when compared T-tube drainage. This implies that ante-grade biliary stent insertion is likely to reduce costs and increase overall patient satisfaction. We support the use of ante-grade biliary stent insertion during LCBDE when primary closure is not preferred.
Keyword T-tube
General surgery
Common bile duct (CBD)
Biliary stent
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
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