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KMID : 1130220220260020140
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Annals of Geriatric Medicine and Research
2022 Volume.26 No. 2 p.140 ~ p.147
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Is Laparoscopic Common Bile Duct Exploration Safe for the Oldest Old Patients?
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Yeon Hee-Jin
Moon Ju-Ik
Lee Seung-Jae
Choi In-Seok
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Abstract
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Background: This study aimed to identify the risk factors for postoperative complications of laparoscopic common bile duct exploration (LCBDE) in the oldest old patients aged 80 years or older.
Methods: From March 2001 to October 2020, 363 patients underwent LCBDE with stone removal. Based on their ages, they were divided into two groups, those younger than 80 years (n=240) and those 80 years old or older (n=123). We compared patient demographics, disease characteristics, surgical outcomes, and postoperative complications based on these groups.
Results: The older group had a higher proportion of patients with a Charlson Comorbidity Index ≥5 (p<0.001) and the American Society of Anesthesiologist (ASA) physical status classification ≥3 (p<0.001). In addition, the older group had longer postoperative hospital stays than younger group (7.5±6.1 days vs. 6.2±3.9 days, p=0.013). However, there were no significant differences between groups according to the postoperative complications (13.8% vs. 20.3%, p=0.130). According to multivariate analysis, the risk factors for postoperative complications were Charlson Comorbidity Index ≥5 (odds ratio [OR]=2.307; 95% confidence interval [CI], 1.162?4.579; p=0.017) and operative time >2 hours (OR=3.204; 95% CI, 1.802?5.695; p<0.001).
Conclusion: In patients with Charlson Comorbidity Index <5 and operation time <2 hours, LCDBE with stone removal can be considered safe for the oldest old patients.
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KEYWORD
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Laparoscopy, Choledocholithiasis, Aged, Postoperative complications, Multivariate analysis
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