[External drainage during surgery for biliary lithiasis. Our present attitude (author's transl)]

Area of Science:

• Hepatobiliary surgery
• Surgical innovation
• Biliary tract procedures

Context:

• External biliary drainage was a common practice in common bile duct surgeries.
• A 20-year review revealed its use in only 4% of common bile duct operations.
• Advancements in surgical methods are impacting standard procedures.

Purpose:

• To evaluate the declining role of external biliary drainage in common bile duct surgery.
• To assess the indications for trans-cystic and Kehr's drain use.
• To highlight the shift towards less invasive or more effective biliary drainage techniques.

Summary:

• External biliary drainage, once routine, is now considered nearly obsolete.
• Trans-cystic drainage is decreasingly indicated with improved intraoperative exploration.
• Kehr's drain retains a limited but essential role in specific conditions, particularly angiocholitis.

Impact:

• This shift signifies progress in hepatobiliary surgery, favoring improved patient outcomes.
• Reduced reliance on external drainage may decrease complication rates.
• The findings guide current surgical practice towards more specialized drainage techniques.