Abstract: Objective To compare the curative effect and the complications of three kinds of surgical treatment in the elderly patients with gallstone complicated with extrahepatic bile duct stone. Methods A total of 178 cases of elderly patients with gallbladder stones complicated with extrahepatic bile duct stones treated in our hospital from July 2016 to June 2019 were selected. Out of them 63 cases were treated by the laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration (LC+LCBDE), 61 cases were treated by endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy (ERCP+LC), and 54 cases were treated by open cholecystectomy combined with open common bile duct exploration (OC+OCBDE). The liver function indexes before and after surgery, operation conditions and the complications after surgery were compared between the three groups. Results The levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin in the three groups 5 d after surgery were significantly lower than those before surgery(P<0. 05). There were no significant differences in the levels of AST and ALT between the three groups before and 5 d after surgery (P>0. 05). The operation time in the OC+OCBDE group was significantly shorter than that in the LC+LCBDE group and the ERCP+LC group (P＜0. 05). The intraoperative blood loss, anal exhaust time and hospital stay in the OC+OCBDE group were increased significantly than those in the LC+LCBDE group and ERCP+LC group(P<0. 05). The incidence rate of postoperative complications in the LC+LCBDE group, ERCP+LC and OC+OCBDE group was 7. 94%, 21. 31% and 25. 93% respectively with statistical difference (P<0. 05). Conclusions The three surgical treatments for gallbladder stones and extrahepatic bile duct stones can effectively remove the stones and improve the liver function. Among them, OC+OCBDE has certain advantages in shortening the operation time, and LC+LCBDE surgery has minimal risk of postoperative complications.

Key words: gallbladder stones, extrahepatic bile duct stones, aged, curative effect, complications