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Updated: Sep 26, 2026
Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
Published on: May 2, 2025
Effect of Common Bile Duct Opening Versus Ligation on Postoperative Outcomes in Patients Undergoing
Hong-Yu Xu1,2, Wei-Zhen Tang1,2, Tai-Hang Liu2
1Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background:
Complications after pancreaticoduodenectomy are common and may be life-threatening. Management of the common bile duct stump may affect biliary pressure, drainage, and postoperative outcomes. This study seeks to compare open versus ligated bile duct stump management during pancreaticoduodenectomy.
Methods:
This retrospective cohort included 125 patients who underwent pancreaticoduodenectomy between 2019 and 2025. Surgical outcomes and postoperative recovery were compared between the open-stump and ligation groups. Multivariable logistic regression identified associations between stump management and postoperative complications; biochemical indicators were also assessed.
Results:
After adjustment, the opening group had significantly lower risks of pancreatic fistula (aOR = 0.18, 95%CI: 0.05 - 0.68, P = 0.011) and intra-abdominal and gastrointestinal bleeding (aOR = 0.09, 95%CI: 0.01 - 0.77, P = 0.028) versus the ligation group. The opening group also demonstrated a shorter surgical duration (315 minutes vs. 420 minutes, P < 0.001), reduced postoperative hospitalization (24 days vs. 30 days, P = 0.002), and lower costs (109,375 RMB vs. 137,518 RMB, P < 0.001). No significant changes were seen in liver function or coagulation markers.
Conclusion:
Keeping the common bile duct open markedly enhances perioperative management during pancreaticoduodenectomy, thus serving as a significant reference for refining surgical protocols.