[Results of the surgical treatment of common bile duct calculi in aged patients].
One hundred and two patients (median age: 76 years old; range: 70-91) underwent choledocotomy for biliary lithiasis. Seventy patients had at least one risk factor, 31 had at least 2 factors and 12 had 3 or 4 factors. The indication for surgical treatment was based on evolutive complications in 64 cases; an elective operation was performed in 38 cases. Common bile duct lithiasis was present in only 87 cases but associated lesions made a choledocotomy necessary in every case. A choledocoduodenostomy was performed in 40 cases and a choledocojejunostomy in 3 cases. No postoperative complications occurred in 86 patients. Of 16 patients with complications, 2 were fatal being due to hemiplegia and respiratory failure respectively. Two patients had residual lithiasis. Ninety-four patients were followed on a long-term basis (median follow-up time: 6 years): 34 died from underlying diseases, while 60 are still alive. Treatment failures were, in one case, recurrent lithiasis treated by choledocoduodenostomy and, in the other case, biliary anastomosis stenosis. These results show that the surgical treatment of choledocolithiasis does not necessarily increase the mortality rate in the elderly.
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008297:Male; D011379:Prognosis; D012086:Reoperation; D013997:Time Factors
Résultats du traitement chirurgical de la lithiase de la voie biliaire principale chez le sujet âgé.