The Clinical Evaluation of Laparoscopic Transcystic Duct Common Bile Duct Exploration in Elderly Choledocholithiasis

摘要

Aims: To evaluate the feasibility and safety of Laparoscopic transcystic duct common bile duct exploralion(.LTCBDF) in elderly patients. Methodology: Between Jan 2010 and Dec 2011, 308 elderly patients (age ≥65 years) with CHD stones underwent surgery . 165 were initially treated with LTCBDE , 143 patients underwent open choledocholi-thotomy surgery. Two groups were compared with operative duration, incidence of posloperative complication, and the average days of in hospital. Results: The LTCMDE was perfomied successlully in 157 of 165 patients 95.15%. 3 cases were converted to laparotomy and the other 5 were changed to laparoscopic choledocholitholomy and T-tube drainage. Allthe elderly patients receiving LTCBDE were dealt with primary closure of cystic duct. There were no severe complications such as bleeding and residual stones.The average duration of surgery was 102±35 min and the mean blood loss 43±20 ml.The postoperative hospital day was 3±0.5 days. 143 patients underwent open cho-ledocholithotomy surgery. There were 2(1.4%) cases abdominal wall incision infection, 5 (3.5%) cases pulmonary infection, 2(1.4%) bile leakage, and 1(0.7%) local bile leakage for part T-tube pulled out postop-eration. The operation duration was about 120 ± 30 minutes, and postoperative hospital day 7± 1.5 days Conclusions: Elective LTCHDE to treat CBD stones in elderly patients is safe and effective.