Year 2013 / Volume 105 / Number 3
Original
Laparoscopic common bile duct exploration and antegrade biliary stenting: Leaving behind the Kehr tube

pp. 125-130

Darío Martínez Baena, Pablo Parra Membríves, Daniel Díaz Gómez y José Manuel Lorente Herce

Abstract
Introduction: single-stage laparoscopic surgery of cholelithiasis and associated common bile duct stones (CL-CBDS) has shown similar results when compared to laparoscopic cholecystectomy combined with ERCP. Classically, choledochorrhaphy has been protected by a T-tube drain to allow external bypass of bile flow. However, its removal is associated with a significant complication rate. Use of antegrade biliary stents avoids T-tube removal associated morbidity. The aim of this study is to compare the results of choledochorrhaphy plus T-tube drainage versus antegrade biliary stenting in our series of laparoscopic common bile duct explorations (LCBDE).

Material and methods: between 2004 and 2011, 75 patients underwent a LCBDE. Choledochorrhaphy was performed following Kehr tube placements in 47 cases and transpapillary biliary stenting was conducted in the remaining 28 patients.

Results: postoperative hospital stay was shorter in the stent group (5 ± 10.26 days) than in the Kehr group (12 ± 10.6 days), with a statistically significant difference. There was a greater trend to grade B complications in the stent group (10.7 vs. 4.3 %) and to grade C complications in the Kehr group (6.4 vs. 3.6 %). There were 3 cases of residual common bile duct stones in the Kehr group (6.4 %) and none in the stent group.

Conclusions: antegrade biliary stenting following laparoscopic common bile duct exploration for CL-CBDS is an effective and safe technique that prevents T-tube related morbidity.
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Darío Martínez Baena, Pablo Parra Membríves, Daniel Díaz Gómez y José Manuel Lorente Herce. Laparoscopic common bile duct exploration and antegrade biliary stenting: Leaving behind the Kehr tube. 125-130


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