SynthesisSurgical endoscopy2016
Systematic review with meta-analysis of studies comparing primary duct closure and T-tube drainage after laparoscopic common bile duct exploration for choledocholithiasis.
Synthesis in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 113 citations in OpenAlex.
- Greater than or equal to 8 mm is a safe diameter of common bile duct for primary duct closure: single-arm meta-analysis and systematic review.Clinical journal of gastroenterology · 2022Pooled it
- Can T-tube drainage be replaced by primary suture technique in laparoscopic common bile duct exploration? A meta-analysis of randomized controlled trials.Langenbeck's archives of surgery · 2020Pooled it
- Laparoscopic common bile duct exploration plus cholecystectomy versus endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy for cholecystocholedocholithiasis: a meta-analysis.Surgical endoscopy · 2019Pooled it
- T-Tube Use After Laparoscopic Common Bile Duct Exploration.JSLS : Journal of the Society of Laparoendoscopic SurgeonsPooled it
- SpyGlass-guided laser lithotripsy versus laparoscopic common bile duct exploration for large common bile duct stones: a non-inferiority trial.Surgical endoscopy · 2021Trial
- The safety and feasibility of laparoscopic common bile duct exploration for treatment patients with previous abdominal surgery.Scientific reports · 2017Trial
- Robotic Cholecystectomy and Common Bile Duct Exploration: Multidisciplinary Approach in a Complex Case of Choledocholithiasis.Journal of clinical medicine · 2026Article
- Article
- Primary Barbed Suture Versus T-Tube Drainage After Laparoscopic Common Bile Duct Exploration: A Randomized Controlled Trial.Health science reports · 2026Article
- Laparoscopic primary suture versus T-tube drainage for choledocholithiasis: a comparative analysis of efficacy and safety.Surgical endoscopy · 2026Article
- Laparoscopic Common Bile Duct Exploration for Choledocholithiasis in a Patient with Situs Inversus Totalis and Prior Total Gastrectomy with Roux-en-Y Reconstruction: A Case Report.Surgical case reports · 2025Article
- Efficacy and safety of primary suture following laparoscopic common bile duct exploration in the treatment of elderly patients with cholecystolithiasis complicated by choledocholithiasis.Frontiers in surgery · 2025Article
- Can laparoscopic common bile duct exploration be performed without any drainage? A propensity score-matched study.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2024Article
- Giant Primary Choledocholithiasis: A Rare Case Report and Comprehensive Review of Literature.Clinical case reports · 2024Article
- The safety and efficacy of primary duct closure after laparoscopic common bile duct exploration in patients with mild-to-moderate calculus-associated acute cholangitis: a retrospective cohort study.Updates in surgery · 2024Article
- The efficacy and safety of laparoscopic common bile duct exploration with primary duct closure for cholecystolithiasis combined with choledocholithiasis.Clinical case reports · 2024Article
- Current Gallstone Treatment Methods, State of the Art.Diseases (Basel, Switzerland) · 2024Review
- Surgical strategies for challenging common bile duct stones in the endoscopic era: A comprehensive review of current evidence.World journal of gastrointestinal endoscopy · 2024Review
- Application of laparoscopic backtracking full-thickness continuous everting suture for non-AOSC choledocholithiasis.BMC surgery · 2023Article
- T‑tube versus internal drainage tube in laparoscopic common bile duct exploration.Experimental and therapeutic medicine · 2023Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWith advances in laparoscopic instrumentation and acquisition of advanced laparoscopic skills, laparoscopic common bile duct exploration (LCBDE) is technically feasible and increasingly practiced by surgeons worldwide. Traditional practice of suturing the dochotomy with T-tube drainage may be associated with T-tube-related complications. Primary duct closure (PDC) without a T-tube has been proposed as an alternative to T-tube placement (TTD) after LCBDE. The aim of this meta-analysis was to evaluate the safety and effectiveness of PDC when compared to TTD after LCBDE for choledocholithiasis.
methodsA systematic literature search was performed using PubMed, EMBASE, MEDLINE, Google Scholar, and the Cochrane Central Register of Controlled Trials databases for studies comparing primary duct closure and T-tube drainage. Studies were reviewed for the primary outcome measures: overall postoperative complications, postoperative biliary-specific complications, re-interventions, and postoperative hospital stay. Secondary outcomes assessed were: operating time, median hospital expenses, and general complications.
resultsSixteen studies comparing PDC and TTD qualified for inclusion in our meta-analysis, with a total of 1770 patients. PDC showed significantly better results when compared to TTD in terms of postoperative biliary peritonitis (OR 0.22, 95% CI 0.06-0.76, P = 0.02), operating time (WMD, -22.27, 95% CI -33.26 to -11.28, P < 0.00001), postoperative hospital stay (WMD, -3.22; 95% CI -4.52 to -1.92, P < 0.00001), and median hospital expenses (SMD, -1.37, 95% CI -1.96 to -0.77, P < 0.00001). Postoperative hospital stay was significantly decreased in the primary duct closure with internal biliary drainage (PDC + BD) group when compared to TTD group (WMD, -2.68; 95% CI -3.23 to -2.13, P < 0.00001).
conclusionsThis comprehensive meta-analysis demonstrates that PDC after LCBDE is feasible and associated with fewer complications than TTD. Based on these results, primary duct closure may be considered as the optimal procedure for dochotomy closure after LCBDE.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.