Ann Geriatr Med Res.  2022 Jun;26(2):140-147. 10.4235/agmr.22.0026.

Is Laparoscopic Common Bile Duct Exploration Safe for the Oldest Old Patients?

• Yeon HJ
• Moon JI
• Lee SJ
• Choi IS

• KMID: 2531904
• DOI: http://doi.org/10.4235/agmr.22.0026

Abstract

Background
This study aimed to identify the risk factors for postoperative complications of laparoscopic common bile duct exploration (LCBDE) in the oldest old patients aged 80 years or older.
Methods
From March 2001 to October 2020, 363 patients underwent LCBDE with stone removal. Based on their ages, they were divided into two groups, those younger than 80 years (n=240) and those 80 years old or older (n=123). We compared patient demographics, disease characteristics, surgical outcomes, and postoperative complications based on these groups.
Results
The older group had a higher proportion of patients with a Charlson Comorbidity Index ≥5 (p<0.001) and the American Society of Anesthesiologist (ASA) physical status classification ≥3 (p<0.001). In addition, the older group had longer postoperative hospital stays than younger group (7.5±6.1 days vs. 6.2±3.9 days, p=0.013). However, there were no significant differences between groups according to the postoperative complications (13.8% vs. 20.3%, p=0.130). According to multivariate analysis, the risk factors for postoperative complications were Charlson Comorbidity Index ≥5 (odds ratio [OR]=2.307; 95% confidence interval [CI], 1.162–4.579; p=0.017) and operative time >2 hours (OR=3.204; 95% CI, 1.802–5.695; p<0.001).
Conclusion
In patients with Charlson Comorbidity Index <5 and operation time <2 hours, LCDBE with stone removal can be considered safe for the oldest old patients.

Keyword

Laparoscopy; Choledocholithiasis; Aged; Postoperative complications; Multivariate analysis