Efficacy and safety of primary closure following laparoscopic choledochotomy in treatment of extrahepatic biliary calculi in elderly patients
Objective To investigate the efficacy and safety of primary suture after laparoscopic choledochotomy in the treatment of elderly patients with extrahepatic bile duct stones.Methods A total of 148 elderly patients with extrahepatic bile duct stones were enrolled in this study.All patients underwent laparoscopic choledochotomy,among whom 88 received primary suture(primary suture group)and 60 underwent routine T-tube drainage(routine group).Surgical-related indicators,chan-ges in inflammatory factor levels,recovery of postoperative gastrointestinal function and incidence of complications were compared between the two groups.Results The operative time,postoperative drainage time,hospital stay,first exhaust time and bowel sound recovery time were significantly shor-ter in the primary suture group than in the routine group(P＜0.05).No statistically significant differences were observed in intraoperative blood loss and overall treatment efficacy between the two groups(P＞0.05).Compared with preoperative levels,the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1β),alanine aminotransferase(ALT),aspar-tate aminotransferase(AST)and total bilirubin(TBIL)increased initially and then decreased in both groups after surgery,with statistically significant differences at different time points(P＜0.05).The serum levels of CRP,TNF-α and IL-1β in the primary suture group were significantly lower than those in the routine group at 1 and 2 days after operation(P＜0.05).The total incidence of postop-erative complications was 3.41％in the primary suture group,which was significantly lower than the 11.67％in the routine group(P＜0.05).No statistically significant difference was observed in the incidence of common bile duct stenosis within 3 months after surgery between the two groups(P＞0.05).Conclusion Primary suture after LCBDE exhibits favorable efficacy in the treatment of eld-erly patients with extrahepatic bile duct stones,which contributes to shorten operative time,relieve in-flammatory response,reduce incidence of postoperative complications,and high safety.
extrahepatic bile duct stoneslaparoscopycommon bile duct explorationpri-mary sutureT-tube drainage
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