Laparoscopic Common Bile Duct Exploration: a Safe and Definitive Treatment for Elderly Patients

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2016 Dec 24

PMID 28008469

Citations 10

Authors

Chufa Zheng

Yaokui Huang

E Xie

Dejin Xie

Yunheng Peng

Xiaozhong Wang

Affiliations

Soon will be listed here.

Abstract

Background: Common bile duct (CBD) stone is one of the most common diseases among elderly people. In recent decades, there are numerous studies regarding the safety and efficacy of laparoscopic common bile duct exploration (LCBDE). Elderly patients are often regarded as high-risk patients because they are more likely to present with age-specific deterioration of organ function and coexisting chronic diseases, which may reduce their tolerance of laparoscopic surgery. Although laparoscopic surgery for choledocholithiasis is now widely accepted as the treatment for CBD stone, its appropriateness for the treatment of elderly patients or those with coexisting high-risk patients has not been well established. Therefore, the objective of this paper is to analyze the safety and efficacy of LCBDE in elderly patients.

Methods: Between January 2012 and November 2015, 376 patients underwent LCBDE in our center. Based on their ages, they were divided into two groups, and a retrospective study was performed. By making comparisons between younger group who were younger than 70 years (n = 253) and elderly group who were 70 years old or older (n = 123), the demographics, clinical characteristics, laboratory data, operative parameters and outcomes were analyzed.

Results: Before operation, elderly patients had more coexisting chronic diseases and risk factors, such as arterial hypertension, heart diseases, pulmonary diseases and previous abdominal surgery (P < 0.05). In both groups, LCBDE was equally successful with a high clearance rate (100 % in elderly patients vs. 98.8 % in younger group, P = 0.554). Besides, the operating time, intraoperative blood loss, postoperative hospital stay, total costs and overall complication showed no significant difference between two groups (P > 0.05). There was no major bile duct injury or death in either group.

Conclusion: Although elderly patients are frequently confronted with coexisting disorders, LCBDE can be considered as a safe and effective technique in choledocholithiasis treatment for elderly patients.

Citing Articles

Index admission vs elective laparoscopic common bile duct exploration: a district general hospital experience over 6 years.

Al-Ardah M, Barnett R, Rotennburg H, Maitland L, Clarke M, Clark J Langenbecks Arch Surg. 2023; 408(1):32.

PMID: 36645510 DOI: 10.1007/s00423-023-02773-z.

Comparison of one-stage laparoscopic common bile duct exploration plus cholecystectomy and two-stage endoscopic sphincterotomy plus laparoscopic cholecystectomy for concomitant gallbladder and common bile duct stones in patients over 80 years old.

Lee S, Choi I, Moon J, Choi Y, Ryu K J Minim Invasive Surg. 2022; 25(1):11-17.

PMID: 35603338 PMC: 8977497. DOI: 10.7602/jmis.2022.25.1.11.

Is Laparoscopic Common Bile Duct Exploration Safe for the Oldest Old Patients?.

Yeon H, Moon J, Lee S, Choi I Ann Geriatr Med Res. 2022; 26(2):140-147.

PMID: 35569921 PMC: 9271399. DOI: 10.4235/agmr.22.0026.

Puncture and discission with a needle: A new method for laparoscopic common bile duct exploration.

Xie Z, Li H, Sun Y, Chen X, Tang C Medicine (Baltimore). 2020; 99(38):e22220.

PMID: 32957359 PMC: 7505297. DOI: 10.1097/MD.0000000000022220.

Laparoscopic common bile duct exploration in patients with previous abdominal biliary tract operations.

Li M, Tao Y, Shen S, Song L, Suo T, Liu H Surg Endosc. 2020; 34(4):1551-1560.

PMID: 32072280 PMC: 7093335. DOI: 10.1007/s00464-020-07429-3.

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