Publication:

Laparoscopic common bile duct exploration with primary closure over an ante-grade biliary stent-our experience

Background Aim of study was the assessment of laparoscopic common bile duct (CBD) exploration with primary closure over an ante-gradely placed endo-biliary stent for CBD stones in terms of operating time, rate of conversion to open procedure, hospital stay, postoperative complications and residual disease.

Methods Our data was analysed retrospectively over a period of 5 years (2015-2020) on all the patients who underwent laparoscopic CBD exploration with primary closure over an ante-gradely placed endo-biliary stent followed by cholecystectomy at SMHS hospital, Srinagar, J and K, India. Total of 30 such patients were identified.

Results The mean procedure time was 93.5±23.16 minutes. There were no intra operative complications encountered in the study. Four patients were converted to open (13.33%). The mean duration of hospital stay was 4.56±1.99 Days. The total number of patients that developed post-operative complications was 7 (23.33%). The most frequently encountered post-operative complication was stent migration (13.33%). The next most common post-operative complication was minor biliary leak (10%) which resolved spontaneously. There was no mortality experienced during the study. Two patients (6.66%) had residual stones and 28 (93.33%) patients had complete clearance of the CBD.

Conclusions Laparoscopic CBD exploration with primary closure over an ante-gradely placed endo-biliary stent is a feasible option and is a safe procedure. Endoscopic removal of the stent can safely be done after an interval of 6-8 weeks.