Analysis Of Safety And Efficacy Of Emergency Biliary Tract Exploration In Elderly People With Moderate To Severe Cholangitis

Objective:In this study,we retrospectively analyzed the perioperative clinical data of 83 elderly patients with moderate to severe cholangitis with a continuous follow-up of six months.To investigate whether it is safe and feasible to perform emergency laparoscopic biliary exploration for elderly patients with cholangitis.It helps hepatobiliary surgeons choose more scientific and reasonable treatment measures,which is important for the systematic and effective treatment of elderly patients with acute cholangitis and can provide a theoretical basis for clinical intervention in a more timely manner.Methods:A retrospective analysis of 83 patients with acute cholangitis who underwent emergency laparoscopic biliary exploration at the Second Department of Hepatobiliary and Pancreatic Surgery,First Hospital of Jilin University,General Surgery Center,from October 2019 to October2021 The 83 patients were divided into three groups according to their age: 60-69 years old group(29 patients),70-79 years old group(29patients),and 80-89 years old group(25 patients).The perioperative data related to the three groups were statistically analyzed to explore the clinical efficacy of emergency biliary tract exploration for the treatment of moderate to severe cholangitis in the elderly.Results:There were no statistically significant differences between the three groups in terms of gender,underlying disease,and previous surgical history(P > 0.05).There were significant changes in white blood cell count,glutamic oxaloacetic transaminase,glutamic alanine transaminase,total bilirubin,and gamma-glutamyl transpeptidase before and after surgery when comparing each group of patients between groups(P <0.05)There were no significant differences in operation time,hospital stay,postoperative hospital stay,intraoperative bleeding,time to exhaustion,and abdominal drainage time in patients of different age groups(P >0.05).There were four postoperative complications: two cases of biliary fistula in the age group of 60-69 years and one case of abdominal bleeding in the age group of 80 years or older,but there was no statistically significant difference in the incidence of complications.Conclusions:Laparoscopic common bile duct exploration is a safe,effective and feasible method for the treatment of moderate to severe cholangitis in the elderly.It should be actively used clinically for patients who meet the indications for the procedure,which is conducive to the systematic and effective treatment of elderly patients with cholangitis.