Laparoscopic common bile duct exploration: a safe and definitive treatment for elderly patients

Zheng, Cong; Huang, Yaokui; Xie, Er-Fu; De-jin, Xie; Peng, Yunheng; Wang, Xiaozhong

doi:10.1007/s00464-016-5257-3

Cited by 25 publications

(15 citation statements)

References 27 publications

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“…In the mid-1990s, Traverso [14], who had done some early LCBDE studies, recommended one-step LCBDE to treat CBD stones, even though he supported the transcystic approach. Similar to Traverso and other scholars' view [4,6,15], we consider that ERCP may lead to disruption of sphincter Of Oddi and induce several postoperative complications such as pancreatitis, bleeding, and perforation.…”

Section: Discussionsupporting

confidence: 67%

“…The WBC count and ALB and TBIL levels were significantly improved regardless of the patients' preoperative criticality and ASA score, and changes in most evaluated parameters were statistically significant. The study results of Liu [5] and Zheng [6], which compared between older than 70 patients and younger than 70 patients, also mentioned that LCBDE was effective for elderly people with CBD stones. Moreover, Zhu [15] reported that LCBDE with T-tube could improve liver function effectively and rapidly.…”

Section: Discussionmentioning

confidence: 92%

“…Therefore, biliary obstruction removal and infection control are the primary treatment measures [1][2][3][4]. With an aging global society, the proportions of elderly patients with complicated AC and systemic concomitant diseases along with AC are gradually increasing [5,6]. At the same time, due to the development of ultrasound puncture drainage and endoscopic techniques, these patients often choose a more conservative treatment strategy to replace classic laparoscopic common bile duct exploration (LCBDE); therefore, the disease is not treated systematically and completely [7][8][9].…”

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confidence: 99%

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Safety and efficacy of emergency laparoscopic common bile duct exploration in elderly patients with complicated acute cholangitis

et al. 2019

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Background 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. Method Elderly 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. Results There 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. 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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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 99%

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Safety and efficacy of emergency laparoscopic common bile duct exploration in elderly patients with complicated acute cholangitis

et al. 2019

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“…(28,29). Furthermore, LCBDE is an effective technique for choledocholithiasis with a proven safety and excellent outcome for elderly patients (30). The common bile duct exploration can be achieved via a transcystic (TC) or transductal (TD) approach.…”

Section: Discussionmentioning

confidence: 99%

A two-stage versus single-stage procedure for the management of cholecysto-choledocholithiasis in elderly patients: a retrospectively cohort study

et al. 2018

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Background: there is an increasing incidence rate of cholecysto-choledocholithiasis associated with the increasing proportion of senile individuals. Methods: a total of 100 elderly patients (over 80 years of age) suffering both from cholelithiasis and choledocholithiasis were retrospectively studied from January 2010 to December 2016. Patients were scheduled for either a single-stage or two-stage procedure. The LCBDE group (n = 54) included cases that underwent a single stage procedure of laparoscopic exploration of the common bile duct combined with cholecystectomy. The ERCP/EST group (n = 46) included cases that underwent a two stage procedure of preoperative endoscopic retrograde cholangiopancreaticography with endoscopic sphincterotomy followed by cholecystectomy. Comorbidity conditions, presenting symptoms, bile duct clearance, length of hospital stay and the frequency of procedural, postoperative and long-term complications were recorded. Results: the LCBDE group had a higher stones clearance rate than the ERCP/EST group (100.0% vs 89.1%, p < 0.05). Postoperative complications and hospitalization length were comparable in the two groups (p > 0.05). There were more procedural complications in the ERCP/EST group than in the LCBDE group (10.8% vs 0%, p < 0.05). Furthermore, a patient in the ERCP/EST group died due to duodenal perforation. More patients in the ERCP/EST group experienced long-term complications than those in the LCBDE group (23.9% vs 3.7%, p < 0.05) during a mean follow-up period of 28.4 months. Conclusions: the single-stage procedure is a safe and effective technique for elderly patients with cholecysto-choledocholithiasis. LCBDE provides a good stone clearance rate with few long term complications.

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“…[5] However, some recent studies proved laparoscopic CBD exploration to be successful in older and cirrhotic patients. [22][23][24] Among our patients, serious secondary conditions were observed in 28.3% cases, including pregnancy in four patients, cirrhosis in four patients and older age in seven patients, and no complication was identified regarding such conditions. Impacted stones comprise the main reasons of failures both in laparoscopic and endoscopic managements.…”

Section: Discussionmentioning

confidence: 68%

Comparison of open, laparo-endoscopic and one-stage laparoscopic approaches for treatment of gallbladder and common bile duct stones

Bayramov¹

2017

Laparosc Endosc Surg Sci

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Laparoscopic common bile duct exploration: a safe and definitive treatment for elderly patients

Abstract: Although elderly patients are frequently confronted with coexisting disorders, LCBDE can be considered as a safe and effective technique in choledocholithiasis treatment for elderly patients.

Cited by 25 publications

References 27 publications

Safety and efficacy of emergency laparoscopic common bile duct exploration in elderly patients with complicated acute cholangitis

Safety and efficacy of emergency laparoscopic common bile duct exploration in elderly patients with complicated acute cholangitis

A two-stage versus single-stage procedure for the management of cholecysto-choledocholithiasis in elderly patients: a retrospectively cohort study

Comparison of open, laparo-endoscopic and one-stage laparoscopic approaches for treatment of gallbladder and common bile duct stones

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