Evaluation of the Outcomes of Primary Closure after Open Common Bile Duct Exploration for Common Bile Duct Stones

Abstract Background The incidence of CBD stone develops in about 10–15% of patients with gall bladder stones and encountered in approximately 7–15% of patients undergoing cholecystectomy. It is common to be treated by endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST), however in cases who has large or multiple CBD stone or difficult to be cleared by ERCP. Aim of the Work To evaluate of the outcomes of primary closure after open common bile duct exploration for removal of common bile duct stones. Methods This descriptive prospective randomized clinical controlled trial was conducted on 30 patients at Hepatobiliary Pancreatic Department (HBP) - Faculty of Medicine – Ain Shams University from January 2022 until March 2023. Primary closure was performed after removal of CBD stones with follow up for 6 months. Results Operative time ranged from 1.3 to 3 hours with mean 2.03 and ± SD 0.48 hours. Biliary leakage was estimated 13.3% of the candidates (4 cases). One of the 30 patients developed CBD stricture. Total and direct bilirubin levels were statistically significant decrease in T and direct bilirubin in follow up “1st 5 days and post-operative 10th day”. Conclusion The primary closure after open common bile duct exploration for removal of common bile duct stones is a safe, effective and time saving procedure.