MANAGEMENT OF CBD STONES: CHOLEDOCHOTOMY WITH PRIMARY REPAIR WITH T–TUBE DRAINAGE VERSUS CHOLEDOCHODUODENOSTOMY

Dr.Priyanka Tiwari; Dr. Sanjay Pandey; Dr.Krishnamurthy

Volume : VIII, Issue : V, May - 2019

MANAGEMENT OF CBD STONES: CHOLEDOCHOTOMY WITH PRIMARY REPAIR WITH T–TUBE DRAINAGE VERSUS CHOLEDOCHODUODENOSTOMY

Dr. Priyanka Tiwari, Dr. Sanjay Pandey, Dr. Krishnamurthy

Abstract :

Gallstone disease , especially cholelithiasis with choledocholithiasi is very common problem in world. The surgical options for its management are choledochotomy with primary repair with T– tube drainage and choledochoduodenostomy. METHODS : It is a retrospective study done in swami vivekanand subharti medical college from 2009–2019 and total 29 patients underwent CBD exploration out of which 14 patient underwent t– tube repair ( Group A ) and 15 patient underwent choledochodudenostomy (Group B) . We studied the indications for CBD exploration for these two surgeries and also compared the mean CBD diameter and its postoperative outcomes in both the groups . RESULT : The mean age of patients in t–tube repair (Group A) was 42.06 yr and choledochoduodenostomy (Group B) was 42 yrs . On evaluation, in all surgery group ( total n= 29 ) cholelithiasis and choledocholithiasis was detected in 18 patients ( 62.06%) , stricture was present in 5 patients ( 17.24% ) , mirzzis in 4 patients ( 13.79%) , pancreatitis 2 patients ( 6.8%) , CBD stent in 2 patients ( 6.8%) . Choledochotomy was done in all 29 patients for removal of stones . Total 29 patients , 14 patients ( 48.27%) under went t–tube repair and 15 patients ( 51.72%) underwent choledochoduodenostomy . Postoperatively , no patient detected bile leak , sump syndrome and recurrence of CBD stones . CONCLUSION : On comparison of two groups t– tube repair was done in 14 patients with mean CBD diameter of 8.82 +– 1.23 mm and choedochodudenostomy was done in 15 patients with mean CBD diameter 13.55+– 1.39 mm . The results were comparable as there was significant difference in the CBD diameter in between the two groups .