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J Minim Access Surg. 2018 Jun 27. doi: 10.4103/jmas.JMAS_129_18. [Epub ahead of print]

Human fibrin sealant reduces post-operative bile leakage of primary closure after laparoscopic common bile duct exploration in patients with choledocholithiasis.

Author information

1
Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China.

Abstract

Context:

Primary closure of the common bile duct (CBD) without drainage is considered a suitable approach after laparoscopic CBD exploration (LCBDE); however, the risk of post-operative bile leakage is high. Up to now, it has not been clear whether human fibrin sealant can reduce post-operative bile leakage of the primary suture.

Aims:

In this study, we evaluated the role of human fibrin sealant in primary closure of the CBD after LCBDE.

Subjects and Methods:

Patients with choledocholithiasis who had undergone primary duct closure of the CBD after LCBDE were divided into two groups according to whether fibrin sealant was used.

Statistical Analysis Used:

Fisher's exact test or the Chi-square test was used for categorical variables to calculate frequencies and percentages between the groups. The Student's t-test was used to compare the means of the continuous variables between the groups.

Results:

The human fibrin sealant group had a lower rate of post-operative bile leakage compared to the other group (P < 0.05). There were no significant differences in additional parameters such as operative time, post-operative stay duration, time to drain removal, bile duct stenosis, acute allergic reaction and overall mortality.

Conclusions:

Human fibrin sealant can reduce post-operative bile leakage in primary closure of CBD after LCBDE in patients with choledocholithiasis.

KEYWORDS:

Bile leak; choledocholithiasis; choledochotomy; fibrin sealant; primary closure

PMID:
29974875
DOI:
10.4103/jmas.JMAS_129_18
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