Results of retrograde transhepatic biliary drainage after a common bile duct exploration for choledocholithiasis

BACKGROUND/AIMS: The purpose of this Study is to assess the benefits of ret rograde transhepatic biliary drainage (RTBD) and a primary closure after a common bile duct (CBD) exploration for patients with choledocholithiasis. METHODOLOGY: We analyzed 143 patients with choledocholithiasis who had been managed by RTBD after undergoing a CBD exploration retrospectively over a 12-year period. The main outcome criteria were frequency of occurrence of p ost-operative complications which needed a relaparotomy and the clinical lo ng-term results. In addition, the radiographic diameter changes of the CBD at the site of the primary closure and liver function tests after RTBD were also evaluated. RESULTS: The frequency of bile peritonitis in the patients undergoing the R TBD procedure was only 0.7% (1 out of 143 cases). Cholangiography via the R TBD tube revealed no severe stenosis at the site of primary closure. Liver function returned to normal on day 3 after RTBD (p<0.05). Recurrence of com mon bile duct stones developed in 2 patients in this series during the foll ow-up (1-12 years). CONCLUSIONS: RTBD and a primary closure of the CBD after CBD exploration ap pears to be a clinically safe and effective method for such patients with c holedocholithiasis who had undergone a complete stone removal intra-operati vely.