Choledochotomy: primary closure versus T-tube. A prospective trial.

From January 1986 until December 1988 twenty two patients entered a prospective trial comparing primary closure versus T-tube drainage after exploratory choledochotomy for lithiasis, giving 11 primary closures (P) and 11 on T-tube (T). Both groups were well matched for age and risk factors. Preoperative values of alkaline phosphatase on day 2 and 7 were significantly lower in case of primary closure (p less than .025). In case of primary closure there was 1 bile leakage without peritonitis. In 9 T-tube biles additional micro-organisms appeared without clinical importance. In each group 1 infectious complication occurred. Post-operative hospital stay was 12 days (P) versus 14 (T) (p less than .05). There was 1 residual lithiasis (P), without detrimental effect on the healing of the primary closure. Endoscopic sphincterotomy and stone extraction was performed. Within the given exclusion criteria closing a choledochotomy primarily is a safe and attractive procedure.