Routine single-incision laparoscopic common bile duct exploration with concomitant cholecystectomy for elderly...

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Geriatric Surgery

Background:

• Single-incision laparoscopic cholecystectomy (SILC) is increasingly popular.
• Limited research exists on SILC for elderly patients.
• Single-incision laparoscopic common bile duct exploration (SILCBDE) has not been studied in this demographic.

Purpose of the Study:

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

Main Methods:

• Observational study of 146 consecutive SILCBDE procedures.
• Retrospective chart review comparing 40 elderly patients (≥65 years) with 106 younger patients.
• Primary outcomes: complications and mortality. Secondary outcomes: operative time, blood loss, conversion rates, hospital stay, and recurrence.

Main Results:

• No mortality observed.
• High bile duct stone clearance rate (98.6%).
• Elderly group showed higher ASA scores, comorbidity, acute cholangitis rates, longer operative time, more blood loss, longer hospital stays, and higher conversion and complication rates (primarily Clavien-Dindo grade I).

Conclusions:

• Routine SILCBDE with concomitant cholecystectomy is safe and effective in elderly patients.
• Outcomes are comparable to younger patients when performed by experienced surgeons.
• Further randomized controlled trials are warranted.