Comparison of laparoscopic common bile duct exploration (LCBDE) combined with primary suture between elderly and younger patients with choledocholithiasis

Abstract

Objective To compare the efficacy and safety of laparoscopic common bile duct exploration (LCBDE) combined with primary suture in elderly and younger patients with choledocholithiasis. Methods From May 2012 to February 2017, 81 cases of choledocholithiasis who were treated in our hospital by LCBDE combined with primary suture were collected retrospectively. They were divided into two groups according to their age, the aged group (≥ 65 years old) and the younger group (<65 years old). Clinical data of the two groups were statistically analyzed by SPSS22.0 software. The measurementdata of perioperative period were expressed as (±s) and compared with independent t test. The incidence of postoperative complications and the data of follow-up were counted in case (%) and compared with fisher test, the difference was statistically significant in P<0.05. Results All the 81 patients had successfully completed operation and had no conversion to open surgery. There was no significant difference in operative time and intraoperative bleeding volume (all P>0.05). Compared with the younger group, the time of postoperative abdominal drainage, the time of getting out of bed, the time of recovery of gastrointestinal function and the duration of hospitalization were significantly prolonged in the elderly group. (all P 0.05). There was one case of residual stone in the elderly group after operation and no recurrence of stone occurred in both groups. Conclusion Laparoscopic exploration of common bile duct combined with primary suture is effective, safe and feasible. The postoperative complications and recurrence of stones are similar to those of young and middle-aged patients, which is suitable for the elderly patients with choledocholithiasis under the strictly surgery indications. Key words: Choledocholithiasis; Laparoscopy; Aged; Suture Techniques; Comparative Effectiveness Research