To evaluate the application value of continuous full-thickness suture with V-Loc? 180 barbed thread (barbed thread) for laparoscopic common bile duct primary closure.

Clinical data of 45 patients with choledocholithiasis who underwent laparoscopic choledocholithotomy in Central Hospital of Jiangmen affiliated to Sun Yat-sen University between January 2014 and December 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the intraoperative suture method of common bile duct, all patients were divided into the barbed suture group (n=23) and control group (n=22). In the barbed suture group, 14 were males and 9 were females with the average age of (56±14) years old, and the common bile duct was continuous full-thickness sutured with barbed thread. In the control group, 11 were males and 11 were females with the average age of (55±14) years old, and the common bile duct was intermittent full-thickness sutured with 3-0 Polysorb^TM thread. Intraoperative and postoperative conditions of the patients in two groups were observed during postoperative follow-up. The suture time of common bile duct in two groups was compared using t test, the incidence of bile leakage was compared using Chi-square test with Yates continuity correction, and the residual stone rate was compared using Fisher's exact probability method.

All patients underwent the surgery successfully. No conversion to open surgery or perioperative death was observed. The suture time of common bile duct in the barbed suture group was (14±3) min, significantly shorter than (48±4) min in the control group (t=-35.472, P<0.05). Two cases of bile leakage was respectively observed in the barbed suture group and control group, and no significant difference was observed in the incidence of bile leakage between two groups (χ²<0.001, P=1.000). One case of residual stone after surgery was respectively observed in the barbed suture group and control group, and no significant difference was observed in the residual stone rate between two groups (P=1.000). No residual stone recurrence or biliary stricture was observed during the follow-up.

Continuous full-thickness suture with barbed thread is a safe and efficacious technique for laparoscopic common bile duct primary closure. It can significantly shorten the suture time without increasing the incidence of postoperative complications.