Background : Many systematic reviews have recently shown that primary closure(PC) of the common bile duct(CBD) after laparoscopic common bile duct exploration(LCBDE) provides better therapeutic outcomes than T-tube drainage(TD) of the CBD after LCBDE. However, TD is still preferred due to various reasons. The aim of this study was to evaluate the safety and effectiveness of Internal stent(IS) after LCBDE compared to TD after LCBDE.

Methods : This retrospective study on surgical efficacy and safety involved 45 patients treated at Hallym university medical center between January 2015 and July 2023. These patients underwent LC + LCBDE for choledocholithiasis and were categorized into IS and T-tube drainage (TD) groups based on the method of closure of the CBD. The basic preoperative information, intraoperative situation, postoperative situation, and complications were analysed and compared between groups.

Results : The baseline characteristics and preoperative information of patients between the 2 groups were balanced. Patients in the IS group had a shorter post operative hospital stay(p < 0.005) than those in the TD group. Postoperative liver function, and complications there was no significant difference between the IS and TD groups. No intraoperative transfusion and postoperative mortality occurred in either group. In one of the TD group patients, in the process of removing the T-tube at 8 weeks after surgery, T-tube fell into the abdominal cavity and had to be re-operation.

Conclusions : Laparoscopic primary closure of CBD is safe and effective for the management of CBD stones, and can be performed routinely as an alternative to T-tube drainage.