Laparoscopic common bile duct exploration; a preferential pathway for elderly patients.

Area of Science:

• Minimally invasive surgery
• Gastroenterology
• Hepatobiliary surgery

Background:

• Laparoscopic common bile duct exploration (LCBDE) is a recommended alternative to ERCP for choledocholithiasis.
• Limited evidence exists on the safety and efficacy of LCBDE in elderly patients.
• This study addresses the gap in knowledge regarding LCBDE in geriatric populations.

Purpose of the Study:

• To evaluate the safety and efficacy of LCBDE in elderly patients.
• To compare outcomes of LCBDE in elderly patients versus younger patients.

Main Methods:

• Retrospective analysis of patients undergoing LC with LCBDE for choledocholithiasis (Jan 2015-Jan 2017).
• Patients were stratified into two groups: <65 years (Group A) and ≥65 years (Group B).
• Comparative analysis of demographics, comorbidities, operative details, and outcomes between groups.

Main Results:

• 124 patients included (65 in Group A, 59 in Group B).
• Elderly patients (Group B) had higher comorbidity and ASA grades.
• No significant differences observed in conversion rates, bile leak, retained stones, Clavien-Dindo complications, or re-intervention rates between groups.

Conclusions:

• LCBDE is a safe and effective procedure for elderly patients with choledocholithiasis, despite increased comorbidities.
• Outcomes of LCBDE in elderly patients are comparable to those in younger patients.
• LCBDE should be offered to elderly patients with choledocholithiasis as an alternative to ERCP.