Laparoscopic Common Bile Duct Exploration for Elderly Patients with Choledocholithiasis: a Systematic Review and Meta-analysis

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2020 Feb 5

PMID 32016517

Citations 6

Authors

Jisheng Zhu

Shuju Tu

Zhengjiang Yang

Xiaowei Fu

Yong Li

Weidong Xiao

Affiliations

Soon will be listed here.

Abstract

Background: Laparoscopic common bile duct exploration (LCBDE) has been becoming more and more popular in patients with symptomatic choledocholithiasis. However, the safety and effectiveness of LCBDE in elderly patients with choledocholithiasis is still uncertain. This meta-analysis is aimed to appraise the safety and feasibility of LCBDE for elderly patients with choledocholithiasis.

Materials And Methods: Studies comparing elderly patients and younger patients who underwent LCBDE for common bile duct stone were reviewed and collected from the PubMed, Medline, EMBASE, and Cochrane Library. Primary outcomes were stone clearance rate, overall complication rate, and mortality rate. Secondary outcomes were operative time, conversion rate, pulmonary complication, bile leakage, reoperation, residual stone rate, and recurrent stone rate.

Results: Nine studies, including two prospective studies and seven retrospective studies, met the inclusion criteria. There were 2004 patients in this meta-analysis, including 693 elderly patients and 1311 younger patients. There was no statistically significant difference between elderly patients and younger patients regarding stone clearance rate (OR 0.73; 95% CI 0.42-1.26; p = 0.25), overall complication rate (OR 1.31; 95% CI 0.94-1.82; p = 0.12), and mortality rate (OR 2.80; 95% CI 0.82-9.53; p = 0.10). Similarly, the operative time, conversion rate, bile leakage, reoperation, residual stone rate, and recurrent stone rate showed no significant difference between two groups (p > 0.05). While elderly patients showed high risk for pulmonary complication (OR 4.41; 95% CI 1.78-10.93; p = 0.001) compared with younger patients.

Conclusion: Although there is associated with higher pulmonary complication, LCBDE is still considered as a safe and effective treatment for elderly patients with choledocholithiasis.

Citing Articles

The effect of laparoscopic cholecystectomy combined with laparoscopic transcystic common bile duct exploration in treatment of cholecystolithiasis combined with choledocholithiasis.

Xu S, Deng C, Tang K, Nian G, Man Z, Yang S Updates Surg. 2025; .

PMID: 39863823 DOI: 10.1007/s13304-025-02110-7.

Experience in laparoscopic transcystic common bile duct exploration for super-elderly patients with choledocholithiasis-A 96-year-old case report.

Zhang Z, Liu L, Zhang C, Liu Z, Zhao Y, Qi H Heliyon. 2025; 11(1):e41204.

PMID: 39790872 PMC: 11712018. DOI: 10.1016/j.heliyon.2024.e41204.

Exploring Risk Factors for Post-operative Complications in Laparoscopic Common Bile Duct Exploration: A Literature Review.

Manasseh M, Elsamalouty I, San C, Kostalas M Cureus. 2024; 16(10):e72570.

PMID: 39474597 PMC: 11519757. DOI: 10.7759/cureus.72570.

Routine single-incision laparoscopic common bile duct exploration with concomitant cholecystectomy for elderly patients: a 6-year retrospective comparative study.

Chuang S, Kuo K, Chuang S, Wang S, Chang W, Hung K Surg Endosc. 2024; 38(11):6963-6972.

PMID: 39375280 DOI: 10.1007/s00464-024-11277-w.

Efficacy and safety of double endoscopy combined with exploration in the treatment of elderly patients with cholecystolithiasis complicated with choledocholithiasis.

Zhao J, Liu X, Huang T BMC Surg. 2024; 24(1):67.

PMID: 38378520 PMC: 10880308. DOI: 10.1186/s12893-024-02352-z.

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