Background : The single-stage combined laparoscopic common bile duct exploration (LCBDE) with cholecystectomy is considered as effective as two-stage – Endoscopic retrograde cholangiopancreatographic (ERCP) stone removal followed by cholecystectomy for the management of patients of gallstones with concurrent biliary ductal stones. However, despite being feasible LCBDE is neither practiced routinely in Indian subcontinent nor has sufficient literature been published to support its routine use. Placement of t-tube during open common bile duct (CBD) exploration adds to postoperative morbidity. Thus, we have conducted this study to assess the perioperative outcomes of primary duct closure and internal biliary drainage in LCBDE.

Methods : This is a prospective cohort study that included n=24 patients with CBD diameters of >9 mm who were operated on between 2019- 2020. LCBDE with primary duct closure over endo-biliary stent was done and their perioperative outcomes were studied along with follow-up at 3 weeks, 3 months and 6 months.

Results : Complete duct clearance was achieved in all patients intraoperatively with a mean operating time of 2.02±0.49 hrs where the time taken for primary duct closure was 13.66±2.68 min. Mean hospital stay was 5.54+1.58 days. N=3 patients developed biliary leak and one had intraabdominal collection postoperatively. One patient in follow up at 3 weeks was found to have retained stone(s) which was managed successfully by ERCP with an uneventful post-procedure period.

Conclusions : The single-stage LCBDE and cholecystectomy with primary duct closure and internal biliary drainage is a feasible procedure with a satisfactory postoperative course.