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the aim is to assess the benefits and harms of T-tube drainage versus primary closure without biliary stent after exploration common bile duct stones
Common Bile Duct Exploration is a surgery that involves opening the main bile duct that drains from liver and gallbladder into the first part of the small intestine (the duodenum). This is needed when a gallstone drops out of the gallbladder into the duct and partially or completely blocks up the duct. This can cause jaundice , fever and chills, severe abdominal pain due to infection / inflammation of the bile duct, gallbladder or pancreas. This most often involves admission to the hospital and urgent intervention. Most commonly, a procedure called an ERCP is used to clear out the stones from the bile duct. If gallbladder will have to be removed soon to prevent this potentially serious condition from occurring again.
During the operation the investigators remove gallbladder then a duct exploration is performed. This involves opening the duct directly and removing the stones.
Prior to Common Bile Duct Exploration surgery, patient will be asked not to eat anything after midnight prior to the surgery. patient will be given specific instructions from the surgeon or anesthesiologist about which medications he should or should not take prior to the surgery. patient should not take any blood thinning medications at least 5 days prior to your operation. This should be discussed with the surgeon at the preop visit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CBD exploration with T-tube | repair of CBD after CBD exploration over T-tube |
| |
| CBD exploration with primary repair | primary repair of CBD after CBD exploration |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| T-tube | Device | T shaped tube used as stent after CBD exploration |
|
| Measure | Description | Time Frame |
|---|---|---|
| bile leak from common bile duct | Assessment which type of repair (with T-tube or primary repair) bile leak will occurs more | baseline |
| Measure | Description | Time Frame |
|---|---|---|
| hospital stay length | Assessment which type of repair (with T-tube or primary repair) patient will stay in the hospital more after CBD exploration | base line |
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Inclusion Criteria:
Exclusion Criteria:
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patient who will undergo CBD exploration for management of CBD stone
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mhamed Abo Elhassan, Master | Contact | +201001311044 | doctor_200799@yahoo.com |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31474445 | Background | Wu X, Huang ZJ, Zhong JY, Ran YH, Ma ML, Zhang HW. Laparoscopic common bile duct exploration with primary closure is safe for management of choledocholithiasis in elderly patients. Hepatobiliary Pancreat Dis Int. 2019 Dec;18(6):557-561. doi: 10.1016/j.hbpd.2019.07.005. Epub 2019 Jul 25. | |
| 31067598 | Background |
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| Guan H, Jiang G, Mao X. Primary duct closure combined with transcystic drainage versus T-tube drainage after laparoscopic choledochotomy. ANZ J Surg. 2019 Jul;89(7-8):885-888. doi: 10.1111/ans.15163. Epub 2019 May 8. |
| 30675097 | Background | Jiang C, Zhao X, Cheng S. T-Tube Use After Laparoscopic Common Bile Duct Exploration. JSLS. 2019 Jan-Mar;23(1):e2018.00077. doi: 10.4293/JSLS.2018.00077. |