Objective: To evaluate the feasibility, safety and clinical efficacy of laparoscopic cholecystectomy combined with intraoperative endoscopic retrograde cholangiopancreatography (IOERCP) for elderly patients with concomitant cholelithiasis and choledocholithiasis.
Methods: Eighty-two elderly patients (≥60 years of age) with concomitant cholelithiasis and choledocholithiasis admitted in the Third Hospital of Mianyang from May 2015 to October 2017 were enrolled. The patients were randomly assigned to two groups by a random number table, and underwent combined treatment of LC and IOERCP (LC plus IOERCP group, 42 cases) and combined treatment of LC and laparoscopic common bile duct exploration (LCBDE) (LC plus LCBDE group, 40 cases). The main clinical variables between the two groups of patients were compared.
Results: The baseline data of the two groups of patients were comparable. There were no significant differences in operative time, intraoperative blood loss and rate of open conversion between the two groups (all P>0.05). The stone residual rate in LC plus IOERCP group was significantly lower than that in LC plus LCBDE group (0 vs. 15.4%, P<0.05). The overall incidence of postoperative complications and incidence of each specific complication showed no significant difference between the two groups (all P>0.05). The hospitalization cost was increased but the length of postoperative hospital stay was reduced in LC plus IOERCP group compared with LC plus LCBDE group (both P<0.05).
Conclusion: LC simultaneously combined with IOERCP is safe and feasible for elderly patients with concomitant cholelithiasis and choledocholithiasis, with advantages such as rapid postoperative recovery, shortened hospital stay, and lower residual stone rate.