Observation on the efficacy of simple primary suture of the common bile duct during laparoscopic common bile duct exploration

doi:10.3877/cma.j.issn.1674-3946.2025.06.016

Abstract

Abstract:

Objective

To explore the efficacy of simple primary suture of the common bile duct during laparoscopic common bile duct exploration (LCBDE) for the treatment of common bile duct stones.

Methods

A retrospective analysis was conducted on the clinical data of 81 patients with common bile duct stones who underwent laparoscopic common bile duct exploration from August 2018 to March 2024. They were divided into the observation group (n=48, simple primary suture group) and the control group (n=33, T-tube drainage group) according to the common bile duct closure method. Data were processed using SPSS 27.0 software. Measurement data were expressed as (±s) and analyzed by independent samples t test; counting data were expressed as [cases (%)] and analyzed by χ² test. P<0.05 was considered statistically significant.

Results

There were no statistically significant differences between the two groups in terms of intraoperative blood loss, total hospitalization cost, pain score on the 1st day after surgery, pain score on the 3rd day after surgery, Activities of Daily Living (ADL) score on the 1st day after surgery, ADL score on the 3rd day after surgery, or the incidence of postoperative bile leakage and bile duct stricture (P>0.05). The operation time and hospital stay in the observation group were shorter than those in the control group, with statistically significant differences (P<0.05). The pain score on the 7th day after surgery in the observation group was significantly lower than that in the control group, and the ADL score on the 7th day after surgery was significantly higher than that in the control group, with statistically significant differences (P<0.05).

Conclusion

Under the premise of strictly grasping the indications, both simple primary suture of the common bile duct and T-tube drainage during LCBDE are safe and feasible minimally invasive treatment methods. Simple primary suture of the common bile duct has the advantages of shorter operation time and shorter postoperative hospital stay, which can promote patients’ early recovery of daily life after surgery.

Key words: Choledocholithiasis, Laparoscopic Common Bile Duct Exploration, Primary Suture, T Tube Drainage

Yusong Xiong, Dongmin Xu, Weiwei Zhang, Yang Wang, Yong Tao, Feng Zhu. Observation on the efficacy of simple primary suture of the common bile duct during laparoscopic common bile duct exploration[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(06): 654-657.

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References 23

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组别	例数	性别（例）	年龄（岁，±s）	谷丙转氨酶（U/L，±s）	谷草转氨酶（U/L，±s）
组别	例数	男/女	年龄（岁，±s）	谷丙转氨酶（U/L，±s）	谷草转氨酶（U/L，±s）
观察组	48	19/29	60.4±13.2	82.2±87.4.	44.1±33.1
对照组	33	13/20	63.6±13.1	99.7±81.4	61.8±50.4
χ²/t值		0.029	-1.095	-0.914	-1.765
P值		0.986	0.277	0.364	0.084
组别	例数	总胆红素（umol/L，±s）	碱性磷酸酶（U/L，±s）	胆总管直径（mm，±s）	结石个数（枚，±s）	体质量指数（kg/m²，±s）
观察组	48	21.3±21.3	138.7±71.4	11.5±3.0	1.8±1.2	23.2±3.4
对照组	33	25.3±24.8	162.8±99.5	12.1±3.2	2.4±1.7	23.2±3.8
χ²/t值		-0.772	-1.195	-0.893	-1.739	0.039
P值		0.442	0.237	0.375	0.088	0.969

组别	例数	性别（例）	年龄（岁，±s）	谷丙转氨酶（U/L，±s）	谷草转氨酶（U/L，±s）
组别	例数	男/女	年龄（岁，±s）	谷丙转氨酶（U/L，±s）	谷草转氨酶（U/L，±s）
观察组	48	19/29	60.4±13.2	82.2±87.4.	44.1±33.1
对照组	33	13/20	63.6±13.1	99.7±81.4	61.8±50.4
χ²/t值		0.029	-1.095	-0.914	-1.765
P值		0.986	0.277	0.364	0.084
组别	例数	总胆红素（umol/L，±s）	碱性磷酸酶（U/L，±s）	胆总管直径（mm，±s）	结石个数（枚，±s）	体质量指数（kg/m²，±s）
观察组	48	21.3±21.3	138.7±71.4	11.5±3.0	1.8±1.2	23.2±3.4
对照组	33	25.3±24.8	162.8±99.5	12.1±3.2	2.4±1.7	23.2±3.8
χ²/t值		-0.772	-1.195	-0.893	-1.739	0.039
P值		0.442	0.237	0.375	0.088	0.969

组别	例数	手术时间（min）	术中出血量（ml）	术后住院天数（d）	住院费用（万元）
观察组	48	128.0±39.4	17.3±16.0	8.0±2.1	1.4±0.3
对照组	33	160.4±77.3	22.4±12.1	9.4±3.3	1.5±0.3
t值		-2.477	-1.559	-2.336	-1.341
P值		0.015	0.123	0.022	0.184

组别	例数	手术时间（min）	术中出血量（ml）	术后住院天数（d）	住院费用（万元）
观察组	48	128.0±39.4	17.3±16.0	8.0±2.1	1.4±0.3
对照组	33	160.4±77.3	22.4±12.1	9.4±3.3	1.5±0.3
t值		-2.477	-1.559	-2.336	-1.341
P值		0.015	0.123	0.022	0.184

组别	例数	时间	VAS评分	ADL评分
观察组	48	1d	2.0±0.6	59.6±7.8
		3d	1.3±0.5	68.3±11.3
		7d	0.4±0.5^a	88.4±10.8^a
对照组	33	1d	2.1±1.1	56.7±5.7
		3d	1.4±0.5	67.2±9.6
		7d	1.5±0.5	79.1±9.6

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