Two-stage versus single-stage procedure for the management of cholecystocholedocholithiasis in elderly patients: a retrospectively cohort study
| Autor: | Guo qin Jiang, Wen Zhang Zha, Yong Zhou, Xu-Dong Wu, Ren-Gen Fan |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 03 medical and health sciences Sphincterotomy Endoscopic 0302 clinical medicine Postoperative Complications medicine Humans Cholecystectomy Stage (cooking) Duodenal Perforation Retrospective Studies Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Common Bile Duct Common bile duct Bile duct Single stage business.industry Gastroenterology Cholecystolithiasis General Medicine Length of Stay medicine.disease Comorbidity Surgery medicine.anatomical_structure Choledocholithiasis Cholecystectomy Laparoscopic 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female Laparoscopy business Cohort study |
| Zdroj: | Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva. 111(3) |
| ISSN: | 1130-0108 |
| Popis: | there is an increasing incidence rate of cholecysto-choledocholithiasis associated with the increasing proportion of senile individuals.a total of 100 elderly patients (over 80 years of age) suffering both from cholelithiasis and choledocholithiasis were retrospectively studied from January 2010 to December 2016. Patients were scheduled for either a single-stage or two-stage procedure. The LCBDE group (n = 54) included cases that underwent a single stage procedure of laparoscopic exploration of the common bile duct combined with cholecystectomy. The ERCP/EST group (n = 46) included cases that underwent a two stage procedure of preoperative endoscopic retrograde cholangiopancreaticography with endoscopic sphincterotomy followed by cholecystectomy. Comorbidity conditions, presenting symptoms, bile duct clearance, length of hospital stay and the frequency of procedural, postoperative and long-term complications were recorded.the LCBDE group had a higher stones clearance rate than the ERCP/EST group (100.0% vs 89.1%, p0.05). Postoperative complications and hospitalization length were comparable in the two groups (p0.05). There were more procedural complications in the ERCP/EST group than in the LCBDE group (10.8% vs 0%, p0.05). Furthermore, a patient in the ERCP/EST group died due to duodenal perforation. More patients in the ERCP/EST group experienced long-term complications than those in the LCBDE group (23.9% vs 3.7%, p0.05) during a mean follow-up period of 28.4 months.the single-stage procedure is a safe and effective technique for elderly patients with cholecysto-choledocholithiasis. LCBDE provides a good stone clearance rate with few long term complications. |
| Databáze: | OpenAIRE |
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