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Updated: Jul 12, 2026
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Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
Published on: May 2, 2025
Continuous Versus Interrupted Primary Closure after Laparoscopic Common Bile Duct Exploration for
Thaís Henriques Abud1, Maria Eduarda Caetano Batista de Paiva1, Mateus Lima Ulisses Trindade1
1Department of Surgery, Heliopolis Hospital, São Paulo, São Paulo, Brazil.
Summary
Continuous suturing (CS) offers a safe and efficient alternative to interrupted suturing (IS) for primary closure after laparoscopic common bile duct exploration (LCBDE). This meta-analysis found CS significantly reduced operative time without compromising patient safety or outcomes.
Area of Science:
- Gastroenterology and Hepatobiliary Surgery
- Minimally Invasive Surgical Techniques
- Evidence-Based Medicine
Background:
- Primary closure is common after laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis.
- The optimal suturing technique for LCBDE closure is not well-established.
- Continuous suturing (CS) and interrupted suturing (IS) are the primary methods compared.
Purpose of the Study:
- To systematically review and meta-analyze the outcomes of continuous versus interrupted suturing for primary closure after LCBDE.
- To compare the efficacy and safety of CS and IS in patients undergoing LCBDE.
Main Methods:
- Systematic literature search across major databases (PubMed, Web of Science, Scopus, Cochrane) up to May 2026.
- Meta-analysis of three observational studies involving 894 patients (419 CS, 475 IS).
- Random-effects models used to calculate pooled odds ratios and mean differences; heterogeneity assessed using I² statistic.
Main Results:
- Continuous suturing (CS) was associated with significantly shorter operative times compared to interrupted suturing (IS) (MD -9.9 minutes; P < .01).
- No significant differences were found between CS and IS regarding intraperitoneal hemorrhage, biliary leakage, surgical site infection, biliary stricture, stone recurrence, hospital stay, or hospitalization costs.
- The analysis included 894 patients, with 419 undergoing CS and 475 undergoing IS.
Conclusions:
- Continuous suturing (CS) appears to be a safe and efficient alternative to interrupted suturing (IS) for selected patients undergoing LCBDE.
- Evidence is limited by the retrospective nature and geographical origin of the included studies (Eastern centers).
- Further prospective studies are warranted to confirm these findings.