Laparoscopic Common Bile Duct Exploration is a Safe and Effective Strategy for Elderly Patients

Laparoscopic cholecystectomy is considered the most effective treatment for gallstones. However, there is no agreement on the treatment of common bile duct stones, which are a common cause of abdominal pain. This article aims to evaluate and analyze the results of common bile duct exploration in elderly patients and compare the results of open and laparoscopic groups. We analyzed a case series of all elderly patients over 70 years who underwent common bile duct exploration in the Department of Hepatobiliary and Pancreatic Surgery between January 2020 and February 2021. All the operating procedures were carried out by the same surgical team. A total of 104 common bile duct explorations were performed on elderly patients with a mean age of 77.4 years (range, 70-87 years). Of these, 50 patients were in the open common bile duct exploration group, while the laparoscopic common bile duct exploration group included 54 patients, with 7 patients converted to open surgery and excluded from analysis. There were no statistically significant differences between the two groups in terms of risk factors before operation, such as hypertension, diabetes, heart diseases, cerebral vascular disease, and previous abdominal surgery. The duration of surgery for the laparoscopic common bile duct exploration group was significantly shorter than that of the open common bile duct exploration group (149.3 +/- 49.0 min versus 191.7 +/- 109.9 min; p = 0.015). Moreover, the laparoscopic common bile duct exploration group had a shorter postoperative hospital stay than the open common bile duct exploration group (10.6 +/- 4.9 days versus14.0 +/- 6.8 days; p = 0.006). Postoperative complications in the open common bile duct exploration group were higher than in the laparoscopic common bile duct exploration group. Laparoscopic common bile duct exploration can be considered a safe and effective treatment for elderly patients with common bile duct stones, not only for young people. Chinese Clinical Trial Registry Unique Identifying Number (UIN): ChiCTR2300071182 (https://www.chictr.org.cn/bin/project/edit?pid=188505).