title: Laparoscopic common bile duct exploration: a safe and definitive treatment for elderly patients.
abstract: Common bile duct (CBD) stone is one of the most common diseases among elderly people. In recent decades, there are numerous studies regarding the safety and efficacy of laparoscopic common bile duct exploration (LCBDE). Elderly patients are often regarded as high-risk patients because they are more likely to present with age-specific deterioration of organ function and coexisting chronic diseases, which may reduce their tolerance of laparoscopic surgery. Although laparoscopic surgery for choledocholithiasis is now widely accepted as the treatment for CBD stone, its appropriateness for the treatment of elderly patients or those with coexisting high-risk patients has not been well established. Therefore, the objective of this paper is to analyze the safety and efficacy of LCBDE in elderly patients.
  
  
  
  Between January 2012 and November 2015, 376 patients underwent LCBDE in our center. Based on their ages, they were divided into two groups, and a retrospective study was performed. By making comparisons between younger group who were younger than 70 years (n = 253) and elderly group who were 70 years old or older (n = 123), the demographics, clinical characteristics, laboratory data, operative parameters and outcomes were analyzed.
  
  
  
  Before operation, elderly patients had more coexisting chronic diseases and risk factors, such as arterial hypertension, heart diseases, pulmonary diseases and previous abdominal surgery (P < 0.05). In both groups, LCBDE was equally successful with a high clearance rate (100 % in elderly patients vs. 98.8 % in younger group, P = 0.554). Besides, the operating time, intraoperative blood loss, postoperative hospital stay, total costs and overall complication showed no significant difference between two groups (P > 0.05). There was no major bile duct injury or death in either group.
  
  
  
  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.
authors.affiliation: Department of General Surgery, the Affiliated Shantou Hospital of Sun Yat-sen University, Guangdong, 515000, China.
authors.forename: Chufa
authors.initials: C
authors.lastname: Zheng
authors.affiliation: Department of General Surgery, the Affiliated Shantou Hospital of Sun Yat-sen University, Guangdong, 515000, China.
authors.forename: Yaokui
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of General Surgery, the Affiliated Shantou Hospital of Sun Yat-sen University, Guangdong, 515000, China.
authors.forename: E
authors.initials: E
authors.lastname: Xie
authors.affiliation: Department of General Surgery, the Affiliated Shantou Hospital of Sun Yat-sen University, Guangdong, 515000, China.
authors.forename: Dejin
authors.initials: D
authors.lastname: Xie
authors.affiliation: Department of General Surgery, the Affiliated Shantou Hospital of Sun Yat-sen University, Guangdong, 515000, China.
authors.forename: Yunheng
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of General Surgery, the Affiliated Shantou Hospital of Sun Yat-sen University, Guangdong, 515000, China. wangxzh@medmail.com.cn.
authors.forename: Xiaozhong
authors.identifier: 0000-0002-1235-0310
authors.initials: X
authors.lastname: Wang
mesh_terms: D000367:Age Factors; D000368:Aged; D016063:Blood Loss, Surgical; D002681:China; D042883:Choledocholithiasis / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Common bile duct stones; Elderly patients; Laparoscopic common bile duct exploration; Laparoscopic surgery