The types of common bile duct surgery performed either via open conventional surgery or laparoscopic surgery are Common Bile duct exploration for stones , common bile duct excision for cancers, cysts and strictures( narrowing) of the bile ducts and Hillary drainage procedures.
Common bile duct ( CBD) surgery as the name suggests involves surgery of the common bile duct either by conventional open surgery or minimal access surgery also called as laparoscopic surgery . Common bile duct is the drainage tube of the liver which drains the liver and pancreatic juices in to small intestines which aids in digestion. The laparoscopic surgery is performed by placing the specialised instruments in the abdomain and performing surgery on the monitor under complete vision.
Common bile duct surgeries are routinely performed surgeries due to various causes and involves appropriate team work. With the advancements of techniques and improvisation of surgical skills the surgical results of common bile duct surgeries have become excellent with time.
Once you are planned for surgery the surgeon will explain all the details , it’s risk involved , informed consent and recovery protocols after the surgery they are planning to perform. Usually the length of the procedure will depend upon the extent of the surgery.
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Indication of Common Bile Duct surgery
They were classified as 27(31.8%) males, and 58 (68.2%) females; their mean age was 45.1 ± 11.5 years. Acute cholecystitis, biliary colic, cholangitis, jaundice, and pancreatitis were the main presentation pre-ERCP in 5(5.9%), 35 (41.2%), 5(5.9%), 36(42.4%), and 4(4.7%) of patients respectively. Sixty-seven (78.8%) of patients underwent single ERCP session, while 18 (21.2%) of them underwent multiple sessions. Very large, multiple large, impacted large stones and failed cannulation were the causes of ERCP failure in 13(15.3%), 17 (20%), 51(60%), and 4 (4.7%) of patients respectively. ERCP was complicated with bleeding, cholangitis, impacted dormia, and pancreatitis in 2.4%, 2.4%, 1.2%, and 3.5% of patients respectively. Table 1 . On univariate analysis, there was a significant correlation between the number of ERCP sessions and post ERCP complications (27.8% complications with multiple sessions vs.4.5% with single ones; P = 0.009). Table 1 .
A: Laparoscopic cholecodoscopic view of CBD stone, B: laparoscopic cholecodoscopic stone extraction, C: laparoscopic primary closure of CBD.
2. Patients and methods
On comparing primary closure with T-tube after LCD, we found a significantly shorter operative time and post-operative hospital stay in the former; similarly, there was shorter operative time and post-operative hospital stay with primary closure technique in different literature studies. Wu et al., 2012 , Podda et al., 2016 , Zhang et al., 2015 , Cai et al., 2012 , Herrero et al., 2013 , and Khaled et al., 2013  However, T-tube was associated with longer postoperative stay and the time until return to work in Leida et al., 2008  study.
The data were collected from our records in our HPB surgery department and the endoscopic unit of hepatology department where written informed consents were obtained from patients regarding procedures, surgeries, and researches . Our work has been reported in line with the STROCSS criteria , with researchregistry4588.