Primary closure of common bile duct following laparoscopic reexploration and choledocholithotomy in 31 patients with a history of biliary tract operation

Objective To investigate the feasibility and safety of primary closure of common bile duct following laparoscopic common bile duct reexploration and choledocholithotomy for recurrent or residual choledocholithiasis in patients with prior biliary surgery.Methods We retrospectively studied the clinical data of 31 patients who were diagnosed recurrent or residual common bile duct (CBD) stones after prior bile duct surgery.All of 31 patients had undergone primary closure following laparoscopic common bile duct reexploration between Jan 2010 and Jan 2014.Results In all the 31 patients,there was no conversion to open surgery.There were no complications due to port placement,postoperative bleeding and mortality.The operation time was (106 ±32) min; the volume of intraoperative blood loss was (52 ± 16) ml; the time of postoperative gastrointestinal function recovery and postoperative hospital stay were (23 ± 3) h,(5.5 ± 1.5) d respectively.Duodenal injury was found and repaired intraoperatively laparoscopically in one patient.Bile leakage occurred in 2 cases recovered by conservative therapy.No postoperative stricture of bile duct,recurrent or residual stones were observed during a period of 1 month to 1 year (mean follow-up 6 months).Conclusions Primary closure following laparoscopic common bile duct reexploration for patients with a past history of biliary tract operation is safe,feasible,and effective procedure in hands of experienced laparoscopic surgeons. Key words: Choledocholithiasis ;  Reoperation ;  Laparoscopes ;  Primary closure