Background: Open biliary surgery followed by Ttube drainage is still a treatment of choice in patients of choledocholithiasis in many hospitals of developing world. The use of T-tube is not without complications. There are limited studies comparing efficacy of internal biliary stents versus T-tube in open CBD exploration to prevent T-tube complications. The present study assesses clinical short term results in patients who underwent open CBD exploration using a biliary stent versus a T-tube decompression method.

Objectives: To compare the clinical outcomes in patients who underwent open CBD exploration using a biliary stent versus as a T-tube decompression method.

Material and Methods: This prospective randomized controlled study was conducted on 50 consecutive patients undergoing open CBD exploration in the Department of Surgery, Government Medical College and Hospital, Chandigarh from June 2012 to October 2014. Patients were randomly allocated into two groups of 25 each to use of a biliary stent (Group A) (Indovasive, India) or a Kehr’s T-tube (Group B), following open CBD exploration.

Results and Analysis: Baseline characteristics of both the groups were comparable. Surgical site wound infection was observed in 64% of group B patients as compared to 4% in group A (p=0.003). There was statistical significant difference in postoperative stay in hospital for patients in Group A (6±3.1days) as compared to Group B (9.6±5.3days). Postoperative VAS was significantly low in group A as compared to group B on 7th postoperative day (p=0.018). 3 patients in group B had retained CBD stone as compared to none in group A. 4 patients underwent readmission and 1 patient required reoperation in group B as compared to 1 readmission and no reoperation in group A.

Conclusion: primary closure of CBD over biliary stent appeared safe and effective with lesser rate of surgical site wound infections, shorter postoperative hospital stay, few readmission rate and less postoperative discomfort in hospital settings where either laparoscopic CBD exploration facility or expertise are not available.