Objective To explore the efficacy and safety of laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) for elderly patients.Methods A retrospective analysis was made on 140 patients undergoing LC and LCBDE from January 2009 to January 2012.The patients were divided into two groups according to age:the elderly group(more than or equal to 65 years,n =42) and the control group (less than 65 years,n =98).Operative time,open conversion rate,postoperative hospital stay,hospital cost and postoperative mortality were compared.Results The hospital cost was (17 149.7 ± 8275.8) yuan in the elderly group,which was significantly higher than that of the control group(13 710.8 ± 5228.4) yuan (t =2.964,P =0.004).There were no significant differences between the two groups in operation time [(100.2 ± 25.8) min vs.(106.3 ± 48.3) min,t =-0.772,P=0.442],open conversion rate [7.1％ (3/42) vs.7.1％ (7/98),x2 =0.000,P=1.000],postoperative hospital stay [(13.0 ± 4.5) d vs.(11.9 ± 4.1) d,t =1.412,P =0.160],and incidence of postoperative complications [16.7％ (7/42) vs.15.3％ (15/98),x2 =0.041,P =0.839].No death occurred in both groups.All the 140 cases were followed up for 8-42 months (mean,25.9 months).Residual stones were found in two cases in the elderly group.1 case underwent choledochoscopic lithotomy via T tube after extracorporeal shock wave lithotripsy 3 months after operation; the other case underwent ERCP + EST 2 months after operation.No residual stone occurred in the control group,stone recurrence was found in 1 case 20 months after operation,and the stone was removed by ERCP + EST.Conclusion LC combined with LCBDE is a safe and effective method not only for young patients but also for elderly patients in the treatment of cholecystolithiasis complicated with choledocholithiasis.%目的 探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合胆总管探查(laparoscopic common bile duct exploration,LCBDE)在老年患者中的安全性及有效性.方法 对2009年1月～2012年1月140例胆囊结石合并胆总管结石行LC联合LCBDE的临床资料进行回顾性分析,按年龄分为老年组(年龄≥65岁,n=42)和对照组(年龄＜65岁,n=98),比较2组手术时间、中转开腹率、术后并发症、术后住院时间、住院费用、术后死亡率有无差异.结果 老年组住院费用(17 149.7 ±8275.8)元,显著高于对照组(13 710.8 ±5228.4)元(t=2.964,P=0.004)；老年组手术时间(100.2±25.8) min与对照组(106.3±48.3) min无统计学差异(t=-0.772,P=0.442)；老年组中转开腹率7.1％ (3/42)与对照组7.1％ (7/98)无统计学差异(x2=0.000,P=1.000)；老年组术后住院时间(13.0±4.5)d与对照组(11.9±4.1)d无统计学差异(t=1.412,P =0.160)；老年组术后并发症发生率16.7％ (7/42)与对照组15.3％ (15/98)无统计学差异(x2=0.041,P=0.839).2组均无死亡病例.140例随访8 ～42个月,平均25.9月:老年组2例结石残留,其中1例术后3个月行体外冲击波碎石后胆道镜经T管窦道取出结石,1例术后2个月行ERCP+ EST取石；对照组无结石残留,1例术后20个月胆道结石复发,行ERCP+ EST取石.结论 LC联合胆总管探查不仅对年轻患者,对老年患者也是安全有效的.
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