title: The Clinical Evaluation of Laparoscopic Transcystic Duct Common Bile Duct Exploration in Elderly Choledocholithiasis.
abstract: Aims: To evaluate the feasibility and safety of Laparoscopic transcystic duct common bile duct exploration(LTCBDE) in elderly patients.
  
  
  METHODS
  Between Jan 2010 and Dec 2011, 308 elderly patients (age 65 years) with CBD stones underwent surgery. 165 were initially treated with LTCBDE, 143 patients underwent open choledocholithotomy surgery. Two groups were compared with operative duration, incidence of postoperative complication, and the average days of in hospital.
  
  
  RESULTS
  The LTCBDE was performed successfully in 157 of 165 patients 95.15%. 3 cases were converted to laparotomy and the other 5 were changed to laparoscopic choledocholithotomy and T-tube drainage. All he 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 choledocholithotomy 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 postoperation. The operation duration was about 120 ± 30 minutes, and postoperative hospital day 7 ± 1.5 days
  
  
  CONCLUSIONS
  Elective LTCBDE to treat CBD stones in elderly patients is safe and effective.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: You-Ming
authors.initials: YM
authors.lastname: Ding
authors.forename: Yun-Gui
authors.initials: YG
authors.lastname: Nie
authors.forename: Ai-Ming
authors.initials: AM
authors.lastname: Zhang
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.forename: Wei-Xing
authors.initials: WX
authors.lastname: Wang
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D042883:Choledocholithiasis / Q000175:diagnosis / Q000601:surgery*; D003135:Common Bile Duct / Q000473:pathology / Q000601:surgery*; D003549:Cystic Duct / Q000473:pathology / Q000601:surgery*; D004322:Drainage; D017558:Elective Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome