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05.11.2015 | Dynamic Manuscript | Ausgabe 8/2016

Surgical Endoscopy 8/2016

Knotless choledochorraphy with barbed suture, safe and feasible

Zeitschrift:
Surgical Endoscopy > Ausgabe 8/2016
Autoren:
Luis C. Fernandez, Augusto Toriz, Jorge Hernandez, Norberto Sanchez, Erick Linares, Massiel Zenteno, Adolfo Cuendis, Jose Olivares, Gustavo Guerrero, Cesar F. Cervantes

Abstract

Purpose

To describe the safety and feasibility of a running continuous unidirectional barbed suture (V-Loc, Covidien, Mansfield, MA) for primary common bile duct closure while performing laparoscopic common bile duct exploration (LCBDE).

Introduction

LCBDE is nowadays the best approach for treating complex common bile duct lithiasis or cases where the endoscopic retrograde cholangiopancreatography has failed. It is clear that the primary closure of the common bile duct must be preferred over the T-tube drainage. The actual technical aspects offer room for improvement. We present our experience with barbed suture, for which recently, various fields of surgery have become interested in and which now has a series of studies that support it for several uses.

Methods

Between July 2012 and July 2014, 54 consecutive patients with bile duct stones underwent LCBDE by a single surgeon. Perioperative outcomes and 30-day complications were recorded.

Results

Upon the completion of the exploration, 50 patients had primary common bile duct closure using knotless unidirectional barbed 3-0 V-Loc 90 suture, and 4 patients were excluded. All of the sutures were performed without knot tying. The procedure in all patients was successfully performed with no intraoperative complications. There were no bile leaks in the 50 patients or other postoperative complications such as infection, need for reintervention or death.

Conclusion

The use of unidirectional knotless barbed suture (V-Loc 90) is safe, feasible and effective on LCBDE for primary common bile duct closure. The biliary leak rate is acceptably low and comparable to the rate reported in the literature. This report is our initial experience that needs further clinical trials.

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Zusatzmaterial
Supplementary material 1 (MOV 32886 kb)
464_2015_4620_MOESM1_ESM.mov
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