Laparoscopic Common Bile Duct Exploration Is a Safe and Effective Strategy for Elderly Patients

Surg Innov. 2018 Oct;25(5):465-469. doi: 10.1177/1553350618785487. Epub 2018 Jul 12.

Abstract

Purpose: Laparoscopic common bile duct exploration (LCBDE) has been widely used to remove common bile duct (CBD) stones. However, surgery is not considered as the first treatment choice for elderly patients with CBD stones because of the potential risk of postoperative complications. This study aims to evaluate the safety and efficiency of LCBDE for elderly patients.

Methods: From April 2011 to October 2016, 265 consecutive patients underwent LCBDE. We performed a retrospective study and divided these patients into 2 groups. The younger group was younger than 70 years old (n = 179), and the elderly group was 70 years old or older (n = 86). We compared patient demographics, clinical characteristics, intraoperative parameters, postoperative complications, and incidence of recurrent stone between the 2 groups.

Results: The elderly patients had higher preoperative morbidity of chronic diseases, such as pulmonary diseases, heart diseases, arterial hypertension, and abdominal operation history ( P < .05). There were no significant differences between the 2 groups in terms of operation time, intraoperative blood loss, conversion rate to open surgery, total cost, overall complications, and incidence of recurrent stone ( P > .05).

Conclusion: LCBDE can also be carried out as a safe and effective approach to remove CBD stones in elderly patients, although they have higher risk of chronic diseases.

Keywords: common bile duct stone; elderly patients; laparoscopic common bile duct exploration.

MeSH terms

  • Adult
  • Aged
  • Biliary Tract Surgical Procedures* / adverse effects
  • Biliary Tract Surgical Procedures* / methods
  • Choledocholithiasis / surgery*
  • Common Bile Duct / surgery*
  • Female
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Young Adult