关键词: 胆总管结石, 腹腔镜, 一期缝合, T管引流, 高龄

Abstract: Objective To investigate the difference in efficacy between primary closure and T-tube drainage following laparoscopic cholecystectomy (LC) with laparoscopic common bile duct exploration (LCBDE) in the treatment of gallbladder stones combined with common bile duct stones in the elderly patients aged≥80 years. Methods The clinical data of 68 patients aged≥80 years undergoing LC+LCBDE from January 2017 to December 2023 at Nanjing First Hospital were retrospectively analyzed. According to the common bile duct suture method, the patients were divided into primary closure group (33 cases) and T-tube drainage group (35 cases). The baseline data, postoperative recovery, postoperative complications and the levels of laboratory indexes were compared between the two groups. Results There was no significant difference in baseline data, postoperative gastrointestinal function recovery time and incidence of complications (abdominal infection, bile leakage, puncture infection, bleeding, jaundice) between the two groups (P>0.05).The operative time and postoperative hospital stay in the primary closure group were shorter than those in the T-tube drainage group (P<0.05).There were no significant differences in the levels of white blood cell count, C-reactive protein, interleukin-6,aspartate aminotransferase, alanine aminotransferase and total bilirubin between the two groups before surgery, the first day and the fifth day after surgery (P>0.05). Conclusions Under strict indications, primary closure of common bile duct after LC+LCBDE in the elderly patients aged ≥80 years will not increase the risk of postoperative complications, which conforms to the concept of rapid rehabilitation, has a high economic application value, and is worthy of promotion.

Key words: common bile duct stone, laparoscopic, primary closure, T-tube drainage, aged