A STUDY OF COMPARISON BETWEEN VICRYL 3-0 AND PROLENE 3-0 IN CASES OF CHOLEDOCHODUODENOSTOMY

Dr Hiren Modi; Dr Kunal Modi; Dr Jatinkumar Modi

Volume : IV, Issue : VIII, August - 2015

A STUDY OF COMPARISON BETWEEN VICRYL 3-0 AND PROLENE 3-0 IN CASES OF CHOLEDOCHODUODENOSTOMY

Dr Hiren Modi, Dr Kunal Modi, Dr Jatinkumar Modi

Abstract :

BACKGROUND: There are various indications of choledochodudenostomy(CDD) like stones, stricture of lower end of common bile duct or as a drainage procedure in periampullary tumors. In this choledocholithiasis is one of the most common and serious disease in biliary tract. In Choledochodudenostomy, side to side anastomosis done between common bile duct and first part of duodenum by interrupted stitches. Various types of suture material are used like dexon, silk, vicryl, prolene. OBJECTIVE: Compare between vicryl 3-0 and prolene 3-0 in cases of choledochodudenostomy and look out for which one is better and less complicative. METHODS: A Prospective randomized study was conducted in civil hospital on 50 patients who presented with common bile duct stones and managed by choledochoduodenostomy. We had a study of 50 cases for choledochoduodenostomy in which 25 cases with vicryl 3-0 and 25 cases with prolene 3-0. RESULTS: In immediate complications 2 out of 50 patients were devloped hemorrhage. In this CDD done with vicryl 3-0 had mortality on 1st post operative day other CDD with prolene 3-0 managed conservatively. Bile leak occur in 10 % patients on 2 to 3rd post operative days. Out of them 2 patients have CDD with vicryl 3-0 and other 3 patients with prolene 3-0. All were managed conservatively. Wound infection occurred in 28 % of patients. In late complications, 3 out of 50 patients devloped cholangitis at on first month follow up. All of them had a history of bile leak. 2 patients had CDD with vicryl 3-0 devloped cholangitis. 3 out of 50 patients developed recurrent stones at 1 year follow up.2 out of 50 patients have CDD with prolene 3-0. CONCLUSION: In our small comparative study of 50 cases between vicryl 3-0 and prolene 3-0, we could not conclude which one is better or less complicative. But in this study bile leak occur more in prolene than vicryl but it is not significant. However recurrent stones common with prolene 3-0 may be due to their non-absorbable nature which was lead to act as a foreign body. Till this time most of the surgeons preferred vicryl 3-0 due to their absorbable nature and least chance of recurrent stones. But in our study use of prolene 3-0 also gave the same results. So prolene 3-0 is as better as vicryl 3-0. Cost effectiveness not considered in this study.