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Updated: Jun 29, 2026
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Primary closure compared with T-tube drainage following laparoscopic common bile duct exploration among elderly
Phu V La1, Hieu T Le2, Thang M Tran3
1General Surgery Department, Can Tho General Hospital, Can Tho, Viet Nam.
Background:
Laparoscopic common bile duct exploration (LCBDE) is commonly used for hepatolithiasis and/or choledocholithiasis, but the ideal method for common bile duct closure remains uncertain, especially for elderly patients (≥65 years). This study compared outcomes of primary closure versus T-tube drainage following LCBDE in elderly patients.
Methods:
Data from elderly patients undergoing LCBDE for hepatolithiasis and/or choledocholithiasis between May 2016 and December 2020 at two Vietnamese hospitals were analyzed. Patients were divided into groups A (T-tube drainage, n = 52) and B (primary closure, n = 57). Propensity score matching (PSM) was utilized to adjust for baseline characteristics, comparing short- and long-term outcomes between groups.
Results:
PSM yielded 56 matched patients. Pre-PSM, group A had longer operating times and hospital stays than Group B (p = 0.001). Group A had higher postoperative complications (17.9 % vs. 7.1 %) but was not statistically significant (p = 0.422). Group A also had more complex biliary stones. Post-PSM, Group B maintained shorter operating times and hospital stays. Regarding long-term results, stone recurrence rates were similar (5.8 % vs. 3.5 %, p = 0.668).
Conclusion:
Primary closure following LCBDE is a safe and effective alternative to T-tube drainage for treating hepatolithiasis and/or choledocholithiasis in elderly patients.
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