The effect of the laparoscopic primary suture of the common bile duct in elderly patients: a retrospective study

Abstract

Background Traditional surgery treatment strategies for elderly patients who were diagnosed as choledocholithiasis combined with cholecystolithiasis include laparoscopic choledocholithotomy, cholecystectomy, and T-tube drainage. However, long-term indwelling T-tube drainage will cause pain and other complications. This study was designed to compare the primary suture of the common bile duct and the T-tube drainage after laparoscopic choledochotomy to study the merits and demerits between primary suture and T-tube drainage in elderly patients. Methods Eighty-five patients were screened from January 2017 to January 2018. All patients were performed laparoscopic surgery. Fifty-six cases were the primary suture group (n=56). Twenty-nine cases were the T-tube group (n=29). Preoperative baseline characteristics, intraoperative and postoperative characteristics of the two groups were compared. Results There were no differences of baseline characteristics in both groups (P>0.05). 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 indwelling time was shorter in the primary suture group(P﹤0.05). And there were statistically significant differences in postoperative total drainage volume on the first day, all drainage tube indwelling time, postoperative total bilirubin and residual stones between the two groups (P<0.05). There were no statistically significant differences of the other intraoperative and postoperative characteristics(P>0.05). There were no pressure sores, hypostatic pneumonia, deep vein thrombosis, serious complications of heart, lung and brain and even death in both groups. Conclusions With accurate preoperative risk assessment and strict treatment of basic diseases in elderly patients, and the stones were removed in laparoscopic surgery, the primary suture in elderly patients is feasible, safe, and valid.