Therapeutic effect of different biliary drainage methods after laparoscopic common bile duct exploration in elderly patients with choledocholithiasis： An analysis based on propensity score matching
- VernacularTitle:基于倾向性评分匹配分析腹腔镜胆总管探查术后胆管不同引流方式对高龄胆总管结石患者的治疗效果
- Author:
Kaifang DU
1
;
Xichun WANG
1
;
Lei WEI
1
;
Changzhi ZHAO
1
;
Zhongyi FENG
1
;
Mingjie CHENG
1
;
Hanshuo LI
1
;
Guiling LANG
1
Author Information
- Publication Type:Journal Article
- Keywords: Choledocholithiasis; Laparoscopic Common Bile Duct Exploration; Aged; Intra-biliary Drainage; T-tube Drainage
- From: Journal of Clinical Hepatology 2025;41(11):2359-2364
- CountryChina
- Language:Chinese
- Abstract: ObjectiveTo investigate the safety and feasibility of intra-biliary drainage tube placement after laparoscopic common bile duct exploration in elderly patients with choledocholithiasis， and to provide more options for surgical procedures in the clinical management of elderly patients with choledocholithiasis. MethodsA retrospective analysis was performed for the clinical data of 52 elderly patients with choledocholithiasis who were admitted to Department of Hepatobiliary Surgery， Affiliated Dalian Friendship Hospital of Dalian Medical University， from November 2021 to October 2024. According to the biliary drainage method after surgery， the patients were divided into internal drainage group with 24 patients and T-tube drainage group with 28 patients， and there were 19 patients in each group after propensity score matching. The two groups were compared in terms of perioperative parameters and postoperative complications. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsCompared with the T-tube drainage group， the internal drainage group had a significantly shorter length of postoperative hospital stay and a significantly lower volume of postoperative bile loss （Z=-2.845 and -5.633， both P<0.05）， while there were no significant differences between the two groups in time of operation， intraoperative blood loss， and drainage tube indwelling time （all P>0.05）. There were no significant differences between the two groups in postoperative bile leak， stone recurrence， biliary stricture， and drainage tube-related complications， and the internal drainage group had a significantly lower total complication rate than the T-tube drainage group ［1 （5.3%） vs 7 （36.8%）， P<0.05］. ConclusionFor elderly patients with choledocholithiasis， intra-biliary drainage tube placement after laparoscopic common bile duct exploration can shorten the length of postoperative hospital stay， reduce bile loss， and lower the incidence rate of postoperative complications， thereby helping to accelerate postoperative recovery.
