Abstract
Background Traditionally, Surgical treatment strategies for elderly patients diagnosed with choledocholithiasis combined with cholecystolithiasis include laparoscopic choledocholithotomy, cholecystectomy, and T-tube drainage. However, T-tube drainage in the biliary tract can still cause pain and other complications. This study was designed to compare the primary closure of choledochotomy and the use of T-tube after laparoscopic choledochotomy to determine whether primary suture can be as feasible and safe as suture with T-tube drainage in elderly patients. Methods From January 2017 to January 2018, 85 patients were selected to undergo laparoscopic surgery. They were divided into two groups: primary suture group (n=56) and T tube group (n=29). Preoperative data, intraoperative index, postoperative complications were recorded. Results There were no differences in preoperative data in both groups. Compared with the T-tube group, the postoperative total drainage volume on the first day and patients of residual stones were fewer, and all drainage tube extubation time was shorter in the primary suture group. And there were statistically significant differences in postoperative TBIL between the two groups. There were no pressure sores, hypostatic pneumonia, deep vein thrombosis, serious complications of heart, lung and brain and even death in both groups. Conclusion Only if accurate preoperative risk assessment and strict treatment of basic diseases in elderly patients, intraoperative fine suture of the common bile duct, primary suture in elderly patients are feasible, safe, and valid after laparoscopic choledochotomy for verification of ductal clearance.
The effect of the laparoscopic primary suture of the common bile duct in elderly patients: a retrospective study