DOI: 10.36347/sjams.2020.v08i12.022

Pages: 2799-2802

Introduction: Choledocholithiasis is the common problem that necessitates surgical intervention. It is managed either by endoscopic sphincterotomy or surgical exploration i.e. choledochotomy. The choice of surgical technique to extract stones from the common bile duct (CBD) depends on local experience, anatomical characteristics and also on the size, location and number of stones. Most authors consider choledochotomy an alternative to failed Transcystic exploration, although some use it exclusively. Objective: To assess the outcome of primary closure of common bile duct after choledochotomy. Methodology: This retrospective case series was conducted at the Department of Surgery, Sheikh Sayera Khatun Medical College & Hospital, Gopalganj, and different Clinical Centers Gopalganj and Dhaka, Bangladesh. Clinical records of all the patients who underwent open CBD exploration with primary closure between January 2017 to December 2019 were retrieved. Patient’s demographics (like age and gender), operative time, duration of hospital stay, and postoperative complications; including bile leakage, biliary peritonitis, subphrenic abscess and postoperative jaundice were recorded on a proforma. Results: A total of 38 patients were found from clinical records having male to female ratio of 1:6.6. Mean (±SD) operating time was 95 (+7) minutes. The overall complication rate was 10.52%. Bile leak was encountered in three (7.89%) patients whereas small subphrenic collection was noticed in one (2.63%) patient who was treated conservatively. None of the patients experienced postoperative jaundice and biliary peritonitis. Mean (±SD) duration of hospital stay was 7.0 (+1.63) days. Conclusion: Primary repair of common bile duct after open choledochotomy is safe and associated with low complication rate.