Shabab Hussain, Viqar Aslam, Sajjad Muhammad Khan, Waqar Alam Jan.
Primary closure of common bile duct after open exploration; frequency of choleducholethiasis and evaluation as a treatment modality in its management.
Professional Med J Jan ;23(03):257-61.

To determine the frequency of choleducholethiasis in patients with symptomatic gall stone disease and evaluation of primary closure of common bile duct without T-Tube placement after open exploration as a treatment modality in its management. Study Design: Prospective (descriptive) study. Setting: Surgical Unit of Postgraduate Medical Institute, Lady Reading Hospital, Peshawar. Period: One year from 15-03-2013 to 15-03- 2014. Subjects and methods: Total 0f 206 patients of symptomatic gallstones disease were included in the study to find out frequency of choledcholithias and patients with common bile duct (CBD) stones were subjected to open choledochotomy and primary choledochorrhaphy, and follow up of patients was done to find out any post operative complication. Results: A total of 206 patients underwent open cholecystectomy during the study period. The age of the patients ranged from 17 to 70 years with mean of 44.24±1.23 years. Most of the patients with symptomatic gall stones disease were female in the age range of 41-50 years. Frequency of choledocholethiasis was 24 out of 206 constituting 11.65%. Among the patients with CBD stones 4 were male constituting 16.6% and 20 were female that is 83.33% with male to female ratio of 1:4 respectively. Mean hospital stay of the patients in which open CBD exploration and primary repair was performed was 7.25±1.45 days. Complications developed in only 4 patients constituting 16.66%. Complications were wound infection in 2 (8.33%) patients, intraabdominal pus collection in 1 (4.16%) patient and bile leak in 1 (4.16%). One patient lost from follow up. In none of the patients retained CBD stones and stricture observed. Conclusions: There should be low threshold for suspecting CBD stones in cases of symptomatic gallbladder stones disease.

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