Abstract

Background: Common bile duct (CBD) stones in elderly patients are often associated with multiple chronic comorbidities, which increase the risk of complications and adversely affect treatment outcomes. Laparoscopic common bile duct exploration (LCBDE) combined with intraoperative choledochoscopy has been increasingly applied; however, data on long-term outcomes in this patient population in Vietnam remain limited. This study evaluates the short-term and long-term outcomes of laparoscopic surgery for the treatment of CBD stones in patients aged ≥60 years.

Methods: A prospective descriptive study was conducted on 110 patients aged ≥60 years who underwent laparoscopic common bile duct exploration with intraoperative choledochoscopy at Can Tho City General Hospital between May 2016 and April 2022. All patients were followed up until September 2025.

Results: The mean age was 73.19 ± 9.03 years, and 70% of patients were female. At least one chronic comorbidity was present in 84.55% of patients. Laparoscopic surgery was successful in 99.09% of cases, with a stone clearance rate of 91.74%. The overall early postoperative complication rate was 8.26%, with bile leakage accounting for 2.75%. The mean operative time was 104.63 ± 35.09 minutes, and the mean postoperative hospital stay was 8.13 ± 4.15 days. With a mean follow-up duration of 5.5 years (3-9 years), 13 patients (11.8%) developed recurrent stones and 2 patients (1.8%) developed biliary strictures. Most recurrent stones and late complications were successfully managed by endoscopic retrograde cholangiopancreatography (ERCP), without the need for reoperation.

Conclusion: Laparoscopic common bile duct exploration combined with intraoperative choledochoscopy is a safe and effective procedure with favorable long-term outcomes for the treatment of common bile duct stones in elderly patients.