The Therapeutic Effects Evaluation Of Super Elderly Patients With Gallbladder With Common Bile Duct Stones Underwent Laparoscopy Surgery

Objectives To compare treatment effect of gallbladder with common bile duct stones insuper elderly patients underwent different surgical method who are80years or older and oflaparoscopic cholecystectomy+choledocholithotomy T tube drainage between different agegroups, to provide theoretical basis for the choice of appropriate surgical method forelderly patients with gallbladder with common bile duct stones.Methods From2010January to2013June, patients of gallbladder with common bileduct stones underwent surgical treatment in hepatobiliary surgery ward of KaiLuangeneral hospital.We set inclusion and exclusion criteria for comparability. Elderlylaparoscopic group included105(A group), elderly open group112(B group), generallaparoscopic group171(C group). To compare and analysis general data, preoperativecoexist disease, operative time, interoperative blood loss, the first meal time,postoperative hospital stays, postoperative CRP numerous, postoperative complicationsbetween A group and B group, general data, preoperative risk factors, surgical result andpostoperative complications between A group and C group.Results Between elderly laparoscopic group (A group) and elderly open group (Bgroup):1. In general data, there were no statistical differences (P>0.05).2. Inpreoperative risk factors, there were no statistical differences (P>0.05).3. In surgicalresult, there was one death case in A group. There were no statistical differences (P>0.05)in operative time. A group showed lower rate than B group in interoperative blood loss,the first meal time, postoperative hospital stays, postoperative CRP numerous withstatistical significance (P <0.05).4. In postoperative complications, A group showedlower rate than B group in wound infection and pneumonia with statistical significance(P <0.05). Between elderly laparoscopic group (A group) and general laparoscopic group(C group):1. In general data, there were no statistical differences (P>0.05).2. Inpreoperative risk factors, A group showed higher rate than C group in angiocardiopathy,chronic obstructive pulmonary disease(COPD), diabetes melitus with statisticalsignificance (P <0.05).3. In surgical result, there was two death cases in two group.There were no statistical differences (P>0.05) in operation time, operation success rate,the stone-free rate, mortality. A group showed higher rate than C group in the first meal time with statistical significance (P <0.05).4. In postoperative complications, A groupshowed higher rate than C group in angiocardiopathy, pneumonia, uroschesis afteroperation with statistical significance (P <0.05).Conclusions Laparoscopic cholecystectomy+choledocholithotomy T tube drainage is asafe and cost-effective alternative for the elderly patients with gallbladder with commonbile duct stones. It has more superiority than open surgery due to smaller operationgallbladder wound, lighter immunoreaction, less interoperative blood loss, faster recovery.As with general group in operation success rate, the stone-free rate, mortality, it showsthat laparoscopic cholecystectomy+choledocholithotomy T tube drainage apply to notonly general patients but also elderly patients.