Laparoscopic common bile duct exploration with primary closure for management of choledoch-olithiasis in elder patients

doi:10.3877/cma.j.issn.1674-0793.2014.05.011

Abstract

Abstract:

Objective

To investigate the safety and feasibility of laparoscopic common bile duct exploration (LCBDE) with primary closure for management of choledocholithiasis in elder patients.

Methods

The clinical data of sixteen elder patients with choledocholithiasis who underwent primary closure of the common bile duct (without T-tube drainage) after LCBDE (group A) was compared with 20 non-elder patients who underwent the same procedure (group B). Both groups were evaluated with regard to operation time, hospital stay, and postoperative complications.

Results

The mean operation time was (116.31±11.31) minutes for group A and (106.80±10.58) minutes for group B; the hospital stay was (10.19±1.22) days for group A and (7.65±0.88) days for group B; both factors showed no significant difference. There were no bile leakage, abdominal bleeding, subphrenic infection and obstructive jaundice after operation in both groups. And there was no significant difference in incision infection, pulmonary infection and recurrence of stones in both groups.

Conculsion

It is safe and feasible for elder patients to have primary closure of the common bile duct without T-tube drainage after laparoscopic choledochotomy.

Key words: Laparoscopy, Choledochotomy, Primary closure, Elder patients

Hongwei Zhang, Yajin Chen, Wenda Li, Zejian Huang. Laparoscopic common bile duct exploration with primary closure for management of choledoch-olithiasis in elder patients[J]. Chinese Archives of General Surgery(Electronic Edition), 2014, 08(05): 386-389.

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URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2014.05.011

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2014/V08/I05/386

Figures/Tables 2

References 8

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项目		研究组	对照组	统计值	P值
例数		16	20	?	?
男:女		6:10	7:13	0.878b	0.878
平均年龄（岁，±s）		81.31±1.14	50.95±10.03	12.01^c	0.000 ^a
体重指数（kg/m²，±s）		21.67±1.47	22.14±1.74	-0.086 ^c	0.275
临床表现		?	?	?	?
?	阻塞性黄疸	5	6	0.936 ^b	0.936
?	急性胆管炎	4	4	0.724 ^b	0.724
胰腺炎病史		1	2	0.690 ^b	0.690
合并糖尿病		8	1	0.002 ^b	0.002 ^a
合并高血压病		12	3	0.000 ^b	0.000^a

项目		研究组	对照组	统计值	P值
例数		16	20	?	?
男:女		6:10	7:13	0.878b	0.878
平均年龄（岁，±s）		81.31±1.14	50.95±10.03	12.01^c	0.000 ^a
体重指数（kg/m²，±s）		21.67±1.47	22.14±1.74	-0.086 ^c	0.275
临床表现		?	?	?	?
?	阻塞性黄疸	5	6	0.936 ^b	0.936
?	急性胆管炎	4	4	0.724 ^b	0.724
胰腺炎病史		1	2	0.690 ^b	0.690
合并糖尿病		8	1	0.002 ^b	0.002 ^a
合并高血压病		12	3	0.000 ^b	0.000^a

组别	例数	平均手术时间（min，±s）	术后肛门排气时间（d，±s）	平均住院天数（d，±s）	结石平均直径（mm，±s）	胆总管的结石位置（例）		结石类型（例）		术后复发例数	术后并发症（例）
组别	例数	平均手术时间（min，±s）	术后肛门排气时间（d，±s）	平均住院天数（d，±s）	结石平均直径（mm，±s）	胆总管胰腺段	十二指肠上段	单发	多发	术后复发例数	切口感染	肺部感染
研究组	16	116.31±11.30	3.50±0.63	10.19±1.22	9.06±2.85（4～15）	11	5	4	12	1	3	2
对照组	20	106.80±10.58	3.20±0.62	7.65±0.88	9.10±2.22（5～14）	13	7	7	13	1	1	0
t/χ²值	?	2.602^a	1.443 ^a	7.250 ^a	-0.044 ^a	1.000^b	1.000 ^b	0.718 ^b	0.718 ^b	0.873 ^b	0.198 ^b	0.109 ^b
P值	?	0.712	0.450	0.177	0.395	1.000	1.000	0.718	0.718	0.873	0.198	0.109

组别	例数	平均手术时间（min，±s）	术后肛门排气时间（d，±s）	平均住院天数（d，±s）	结石平均直径（mm，±s）	胆总管的结石位置（例）		结石类型（例）		术后复发例数	术后并发症（例）
组别	例数	平均手术时间（min，±s）	术后肛门排气时间（d，±s）	平均住院天数（d，±s）	结石平均直径（mm，±s）	胆总管胰腺段	十二指肠上段	单发	多发	术后复发例数	切口感染	肺部感染
研究组	16	116.31±11.30	3.50±0.63	10.19±1.22	9.06±2.85（4～15）	11	5	4	12	1	3	2
对照组	20	106.80±10.58	3.20±0.62	7.65±0.88	9.10±2.22（5～14）	13	7	7	13	1	1	0
t/χ²值	?	2.602^a	1.443 ^a	7.250 ^a	-0.044 ^a	1.000^b	1.000 ^b	0.718 ^b	0.718 ^b	0.873 ^b	0.198 ^b	0.109 ^b
P值	?	0.712	0.450	0.177	0.395	1.000	1.000	0.718	0.718	0.873	0.198	0.109

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