Prevention of bile leakage after laparoscopic primary suturing of common bile duct by transabdominal placement of nasal bile duct

Objective To study the advantages of laparoscopic primary suturing of common bile duct plus transabdominal nasobiliary drainage in reducing the rate of bile leakage. Methods The clinical data of laparoscopic primary suturing of common bile duct with or without nasal bile duct drainage in Second People's Hospital of Chengdu were analyzed retrospectively. Results During laparoscopic common bile duct exploration, 286 patients were treated by primary suturing without nasobiliary drainage (group without drainage), including 32 (11.2%) patients with bile leakage; 350 patients were treated by primary suturing with transabdominal nasobiliary drainage (group with drainage), including 11 (3.1%) patients with bile leakage. The incidences of bile leakage of the two groups were significantly different (P 0.05). Conclusions The choice after laparoscopic primary suturing of common bile duct between with or without nasobiliary drainage should be determined according to the diameter of common bile duct. When a common bile duct diameter of less than 11.0 mm, nasobiliary drainage is recommended to reduce the rate of bile leakage. Key words: Choledocholithiasis; Laparoscope; Choledochoscope; Nasobiliary duct