OBJECTIVE
The aim is to evaluate the safety and effectiveness of the primary suture of the common bile duct (CBD) compared with laparoscopic choledochostomy when performing laparoendoscopic interventions on the common bile duct in patients with cholecystocholedocholithiasis and cholangitis.
MATERIAL AND METHODS
For the period from 2015 to 2021 years, 2218 patients with cholelithiasis aged 18 to 96 years were operated on. The combination of gallbladder and CBD stones was detected in 288 patients (13.0%). In this group, one-stage laparoendoscopic operations were undertaked in 177 patients (61.5%) herewith in 120 patients, choledochostomy was completed by choledochostomy, and in 30 patients, a primary suture was applied to the common bile duct.
RESULTS
Among 177 simultaneous operations on the common bile duct, laparoscopic intervention was completed endovideosurgically in 150 patients and in 27 cases (15.3%) the transition to open access was carried out. Postoperative morbidity occurred in 23 out of 150 (15.3%) patients who underwent laparoscopic interventions for cholecystocholedocholithiasis. Among 120 patients, where the operation was completed by external drainage of the OGP, complications were observed in 19 cases (15.8%). In the group of 30 patients where the primary suture of hepaticocholedocha was performed, morbidity occurred in 4 (13.3%) patients. Among 150 patients who underwent laparoscopic surgery on the common bile duct, 2 patients died, which accounted for a postoperative mortality of 1.3%.
CONCLUSION
The primary suture of the common bile duct is feasible, relatively safe and effective method of completing laparoscopic choledecholithotomy. It is well tolerated by patients, relieves patients of the need for temporary external bile fistula, improves quality of life, reduces the length of patient`s stay in hospital and the period of outpatient rehabilitation.