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Updated: Jul 21, 2026
Application of Laparoscopic Ultrasonography in Primary Choledochal Suture during Combined Two-lens Surgery
Published on: March 28, 2025
Laparoscopic primary suture versus T-tube drainage for choledocholithiasis: a comparative analysis of efficacy and
Hongrui Zeng1, Jingjing Li2, Yan Liu1
1Department of Hepatobiliary Surgery, Chongqing University Three Gorges Hospital, Wanzhou District, Chongqing, China.
Background:
Laparoscopic common bile duct exploration (LCBDE) is an important surgical treatment for choledocholithiasis; however, the choice between indwelling T-tube placement and primary suture remains controversial. This study aimed to evaluate the safety and feasibility of LCBDE coupled with primary suture using a prospective cohort design, as well as to summarize the key techniques of primary suturing.
Methods:
Patients with choledocholithiasis who met the inclusion criteria between January 2019 and March 2023 were enrolled. The primary suture group comprised patients who underwent LCBDE with primary closure, while the T-tube drainage group consisted of those who received LCBDE with T-tube drainage. Perioperative data and follow-up outcomes were collected and statistically analyzed for both groups.
Results:
Operative time (120.00 [100.00-139.50] vs. 99.00 [85.00-118.50] min; P = 0.000) and postoperative hospital stay (7.00 [5.00-9.00] vs. 5.00 [4.00-6.00] days; P = 0.000) differed significantly between groups. No significant differences were observed in estimated blood loss (40.7 ± 24.1 vs. 41.4 ± 23.7 mL; P = 0.537), conversion rate to laparotomy (2.38% vs. 2.27%; P = 0.918), time to gastrointestinal function recovery (2.1 ± 0.7 vs. 2.0 ± 0.6 days; P = 0.317), or postoperative complication rate (2.92% vs. 3.18%; P = 0.959). During follow-up, one case of common bile duct (CBD) stenosis and one case of extrahepatic cholangiocarcinoma occurred in the T-tube group; no such complications were observed in the primary suture group. The rates of residual stones (1.75% vs. 0.45%; P = 0.225) and recurrent stones (1.75% vs. 1.81%; P = 0.980) were without statistical significance.
Conclusion:
In our grouping situation, LCBDE and primary suture is safer and more feasible than T-tube drainage in operative time and postoperative hospital stay. This conclusion has certain reference value for clinicians to choose the surgical method in laparoscopic surgery for choledocholithiasis.
