Short-term outcomes of laparoscopic common bile duct exploration for choledocholithiasis in elderly patients: a comparative single-centre study.

Abstract

Introduction: Laparoscopic common bile duct exploration (LCBDE) is an alternative to endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of choledocholithiasis. However, its use in elderly patients has been limited, often avoided due to concerns about associated morbidity. This study aims to evaluate the success rate and outcomes of LCBDE in elderly patients.

Methods: A retrospective study was conducted on patients with a confirmed diagnosis of choledocholithiasis via intraoperative cholangiography who underwent LCBDE from January 2009 to December 2022. Demographic, clinical, intraoperative, and postoperative data were collected. Patients were divided into two groups: those aged ≥ 70 years and those aged < 70 years. Additionally, a subgroup analysis was performed on patients aged ≥ 80 years.

Results: A total of 330 patients were included (< 70 years = 168; ≥ 70 years = 162). The success rate of LCBDE in patients aged ≥ 70 years was similar to that in patients aged < 70 years (95.7% vs 97%; p = 0.514). No statistically significant differences were found in intraoperative outcomes, short-term complications, or mortality between the two groups. These results were consistent in the subgroup analysis of patients aged ≥ 80 years (n = 67) compared with those aged < 70 years.

Conclusion: LCBDE is a safe and effective procedure for patients aged ≥ 70 years and could be considered a first-line therapeutic option for this group.