Keywords : choledocolithotomy and insertion of a t-tube
A PROSPECTIVE COMPARATIVE STUDY OF THE OUTCOMES BETWEEN CHOLEDOCHODUODENOSTOMY AND CHOLEDOCHOLITHOTOMY WITH T-TUBE CLOSURE IN MULTIPLE CBD STONE
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 5, Pages 16-20
Background: Common Bile Duct Stones (CBDS) are one of the medical conditions leading to surgical intervention. They may occur in 3% 14.7% of all patients for whom cholecystectomies are performed. When patients present with CBD STONES, the one important question that should be answered: what is the best modality of treatment under the given conditions? There are competing technologies and approaches for diagnosing CBDS regarding diagnostic performance characteristics, technical success, safety, and cost effectiveness.
Aim and Objectives of the study: The objective of the study to compare the outcomes of Choledochoduodenostomy (CDD) versus choledocholithotomy and insertion of a T-tube in subjects with multiple CBD stones.
Methodology: This study was conducted in the Dept. of Surgery, Tripura Medical College. we included a total of 60 subjects divided into two groups, Group A and Group B with 30 subjects in each group. Group A underwent choledocholithotomy and insertion of a T-tube and Group B underwent Choledochoduodenostomy. Details of the study were told to the patient and informed consent was taken. After obtaining consent, the patient underwent procedure as per the study design. We compared the parameters, mean operating time (minutes), mean duration of stay at hospital (days), frequency of wound infection and post-operative serum bilirubin.
Results: We compared mean operating time (minutes), mean duration of stay at hospital (days), frequency of wound infection and post-operative serum bilirubin between the two groups. The Mean operating time (minutes), mean duration of stay at hospital (days), frequency of wound infection and post-operative serum bilirubin in Group A were 68 ± 11.8, 8 ± 1.82, 11% and 0.78 ± 0.33 in Group B were 98.6 ± 10.1, 14 ± 3.21, 26% and 1.7 ± 0.97 respectively. There was statistically significant difference in all the parameters between the two groups.
Conclusion: Both Choledochoduodenostomy and T-tube drainage after CBD exploration are equally good procedures for the treatment of uncomplicated choledocholithiasis. However, choledocolithotomy and insertion of a T-tube is having significantly lower operating time and
less duration of stay at hospital. Therefore, it can be recommended for treatment in selective patients of choledocholithiasis.