Abstract
BackgroundAcute cholangitis (AC) is an acute inflammation of the biliary tract caused by bacterial infection, which occurs due to biliary obstruction primarily because of bile duct stones. We aimed to study the effect of laparoscopic common bile duct exploration in the treatment of complicated AC for elderly patients.MethodElderly patients with complicated AC admitted to our hospital from August 2014 to August 2018 were considered. According to the patients’ general conditions and the American Society of Anesthesiologists’ (ASA) grade, 98 patients were divided into three groups: ASA grade II, 38 patients; ASA grade III, 33 patients; and ASA grade IV, 27 patients; all patients underwent emergency laparoscopic common bile duct exploration within 8 h of admission. The perioperative data of these patients were analyzed.ResultsThere were no significant differences between the three groups in preoperative laboratory test results, except for albumin levels. Conversely, when compared in every group, there were some significant differences in changes between pre- and postoperative laboratory test results, except for albumin levels. There were no significant differences between the groups in terms of perioperative data (operation time, blood loss, peritoneal drainage time, postoperative time to flatus, and postoperative hospital stay). Although four patients had postoperative complications, there were no significant differences in the rate of complications between the groups.ConclusionLaparoscopic common bile duct exploration is a safe, effective, and feasible method for treating complicated AC in elderly patients. It should be actively used in clinical work to rapidly relieve biliary obstruction.
Highlights
Acute cholangitis (AC) is an acute inflammation of the biliary tract caused by bacterial infection, which occurs due to biliary obstruction primarily because of bile duct stones
The inclusion criteria were age > 65 years, emergency admission, satisfying the diagnostic criteria for AC specified in the Tokyo Guidelines [10], higher than normal levels of leucocytes and total bilirubin (TBIL), imaging findings suggestive of calculus, extrahepatic biliary obstruction with intrahepatic and extrahepatic bile duct dilatation larger than 10 mm, and associated diseases that could lead to increased perioperative risks
Patients differ significantly in terms of their clinical symptoms, physical signs, and actual physical condition owing to their declining physiological condition and reduced immunity
Summary
Acute cholangitis (AC) is an acute inflammation of the biliary tract caused by bacterial infection, which occurs due to biliary obstruction primarily because of bile duct stones. We aimed to study the effect of laparoscopic common bile duct exploration in the treatment of complicated AC for elderly patients. Results There were no significant differences between the three groups in preoperative laboratory test results, except for albumin levels. When compared in every group, there were some significant differences in changes between pre- and postoperative laboratory test results, except for albumin levels. There were no significant differences between the groups in terms of perioperative data (operation time, blood loss, peritoneal drainage time, postoperative time to flatus, and postoperative hospital stay). Conclusion Laparoscopic common bile duct exploration is a safe, effective, and feasible method for treating complicated AC in elderly patients. It should be actively used in clinical work to rapidly relieve biliary obstruction
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