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腹腔镜经胆囊管胆总管探查术治疗超高龄胆总管结石患者的经验——1例96岁病例报告

Experience in laparoscopic transcystic common bile duct exploration for super-elderly patients with choledocholithiasis-A 96-year-old case report.

作者信息

Zhang Zongming, Liu Limin, Zhang Chong, Liu Zhuo, Zhao Yue, Qi Hui, Yang Haiyan, Wan Baijiang, Zhu Mingwen, Deng Hai, Feng Jinqiu, Liu Fucheng, Guo Zhentian, Yao Peijie

机构信息

Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing, 100073, China.

Key Laboratory of Geriatrics (Hepatobiliary Diseases), China General Technology Group, Beijing, 100073, China.

出版信息

Heliyon. 2024 Dec 12;11(1):e41204. doi: 10.1016/j.heliyon.2024.e41204. eCollection 2025 Jan 15.

DOI:10.1016/j.heliyon.2024.e41204
PMID:39790872
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11712018/
Abstract

BACKGROUND: Super-elderly patients with choledocholithiasis are considered to be at high risk for undergoing surgery. While laparoscopic transcystic common bile duct exploration (LTCBDE) is regarded as a challenging procedure for super-elderly patients with choledocholithiasis, there have been no reported cases of its use in super-elderly patients over the age of 96. CASE SUMMARY: This case study presents the case of a 96-year-old female patient with acute calculous cholecystitis and choledocholithiasis. Despite the presence of multiple high-risk comorbidities, the patient underwent with laparoscopic cholecystectomy (LC) plus LTCBDE, with appropriate perioperative safety measures in place, and made a full recovery, being discharged from the hospital on the seventh day following the operation. CONCLUSION: The case study demonstrates the successful treatment of a 96-year-old patient with choledocholithiasis via LTCBDE, utilising skilled laparoscopic and choledochoscopic techniques along with robust perioperative safety measures. This achievement sets a historical precedent for the successful treatment of a 96-year-old patient with choledocholithiasis via LTCBDE, both domestically and internationally.

摘要

背景：胆总管结石的超高龄患者被认为手术风险很高。虽然腹腔镜经胆囊管胆总管探查术（LTCBDE）对于患有胆总管结石的超高龄患者来说是一项具有挑战性的手术，但尚无96岁以上超高龄患者使用该手术的病例报道。 病例摘要：本病例研究介绍了一名96岁患有急性结石性胆囊炎和胆总管结石的女性患者。尽管存在多种高危合并症，但该患者在采取了适当的围手术期安全措施后，接受了腹腔镜胆囊切除术（LC）加LTCBDE，并完全康复，术后第七天出院。 结论：该病例研究表明，通过LTCBDE成功治疗了一名96岁的胆总管结石患者，采用了熟练的腹腔镜和胆道镜技术以及强有力的围手术期安全措施。这一成果在国内外开创了通过LTCBDE成功治疗96岁胆总管结石患者的历史先例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fd/11712018/4ac836786ec6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fd/11712018/2ab2d2baf198/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fd/11712018/881a17783ef9/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fd/11712018/4ac836786ec6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fd/11712018/2ab2d2baf198/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fd/11712018/881a17783ef9/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fd/11712018/4ac836786ec6/gr3.jpg

相似文献

[1]
Experience in laparoscopic transcystic common bile duct exploration for super-elderly patients with choledocholithiasis-A 96-year-old case report.

Heliyon. 2024-12-12

[2]
Laparoscopic transcystic common bile duct exploration in patients with a nondilated common bile duct.

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[3]
Laparoscopic Transcystic Common Bile Duct Exploration: 8-Year Experience at a Single Institution.

J Gastrointest Surg. 2023-3

[4]
Surgical methods of treatment for cholecystolithiasis combined with choledocholithiasis: six years' experience of a single institution.

Surg Endosc. 2022-7

[5]
Laparoscopic Transcystic Common Bile Duct Exploration in the Elderly is as Effective and Safe as in Younger Patients.

J Laparoendosc Adv Surg Tech A. 2017-1

[6]
Diagnostic performance of laparoscopic transcystic common bile duct exploration for the detection of choledocholithiasis in patients with negative MRCP.

Updates Surg. 2023-10

[7]
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Surg Endosc. 2021-12

[8]
Cost-effective management of complicated choledocholithiasis: laparoscopic transcystic duct exploration or endoscopic sphincterotomy.

J Am Coll Surg. 1996-6

[9]
The Clinical Evaluation of Laparoscopic Transcystic Duct Common Bile Duct Exploration in Elderly Choledocholithiasis.

Hepatogastroenterology. 2014-6

[10]
Transcystic versus traditional laparoscopic common bile duct exploration: its advantages and a meta-analysis.

Surg Endosc. 2018-6-25

引用本文的文献

[1]
Challenges of minimally invasive treatment for acute obstructive suppurative cholangitis in elderly patients.

Chin Med J (Engl). 2025-9-5

[2]
Integrative machine learning model for subtype identification and prognostic prediction in lung squamous cell carcinoma.

Discov Oncol. 2025-5-23

本文引用的文献

[1]
Single-Stage Laparoscopic Common Bile Duct Exploration and Cholecystectomy Versus Two-Stage Endoscopic Stone Extraction Followed by Laparoscopic Cholecystectomy for Patients With Cholelithiasis and Choledocholithiasis: A Systematic Review.

Cureus. 2024-2-22

[2]
The Management of Biliary Disease in Patients with Severe Obesity Undergoing Metabolic and Bariatric Surgery-An International Expert Survey.

Obes Surg. 2024-4

[3]
Comparison of Efficacy of ERCP+LC and LC+LCBDE on Cholecysto-Choledocholithiasis and Analysis of Risk Factors for Recurrence of Choledocholithiasis.

Altern Ther Health Med. 2024-7

[4]
Hotspots and difficulties of biliary surgery in older patients.

Chin Med J (Engl). 2023-5-5

[5]
Current management of concomitant cholelithiasis and common bile duct stones.

World J Gastrointest Surg. 2023-2-27

[6]
Laparoscopic Transcystic Common Bile Duct Exploration: 8-Year Experience at a Single Institution.

J Gastrointest Surg. 2023-3

[7]
Five-Year Experience with Transcystic Laparoscopic Common Bile Duct Exploration.

J Laparoendosc Adv Surg Tech A. 2023-3

[8]
Critical values of monitoring indexes for perioperative major adverse cardiac events in elderly patients with biliary diseases.

World J Clin Cases. 2022-7-16

[9]
Surgical risk assessment for super-elderly patients.

Geriatr Gerontol Int. 2022-4

[10]
Laparoscopic transcystic common bile duct exploration in patients with a nondilated common bile duct.

Ann Palliat Med. 2021-12

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