Is an 8 mm cutoff necessary when performing primary common bile duct closure after laparoscopic common bile duct exploration?

OBJECTIVE

To evaluate whether the efficacy and safety of primary duct closure(PDC) was limited to patients with a wider common bile duct(CBD) (≥8 mm).

METHODS

A retrospective study of patients who underwent PDC after laparoscopic common bile duct exploration (LCBDE) at Taicang Affiliated Hospital of Soochow University from March 2012 to June 2019 was performed. Fifty-five patients were enrolled and classified into two groups according to the diameter of the CBD: the wider group (Group-W, CBD diameter≥8 mm, n=36) and the slender group (Group-S, CBD diameter<8 mm, n=19). The clinical data were compared and analysed.

RESULTS

No significant difference in the mean operative time, mean hospital stay or mean total charge was observed. Bile leakage occurred in 5.26%(1/19) of patients in Group-S, which accounted for only 1.81% (1/55) of total patients. There were no severe complications or mortality in either group. No significant differences in the rate of stone recurrence were observed. No biliary stricture occurred during follow-up.

CONCLUSIONS

PDC may not be limited by the slender CBD (<8 mm), and the proper selection of patients and the standard surgical procedure are particularly important.