Therapeutic experience of 289 elderly patients with biliary diseases

Figure 1 Pancreatoduodenectomy in a 73-year old female patient with bile duct carcinoma. A: Three-dimensional computed tomography reconstruction found an extrahepatic bile duct obstruction (arrow); B: MRI coronal image confirmed entire extrahepatic bile duct obstruction (arrows); C: Tumor (arrow) seen at the incision of the common bile duct; D: Tumor (arrow) seen in the common bile duct by intraoperative choledochoscopy; E: Upper cut end of the hepatic common duct (arrows); F: The cut end of the pancreas (arrow), and the portal vein; G: Child anastomosis (arrows); H: Resected specimen following pancreatoduodenectomy; I: Papillary adenocarcinoma of extrahepatic bile duct, including the hepatic common duct, common bile duct and Vater ampulla. Hematoxylin and eosin staining. Objective magnification, × 40.

Figure 2 Laparoscopic cholecystectomy in a 78-year-old male patient with acute calculous cholecystitis. A: Pus (arrow) surrounding the gallbladder; B: Pus (arrow) in the lumen of the gallbladder; C: Congestion and edema of the gallbladder wall (arrow); D: Ordinary silk thread to ligate cystic duct (arrow); E: Inflammatory adhesion (arrow) of gallbladder bed; F: Wound after cholecystectomy.

Figure 3 Post-operative complications occurred in 68 elderly patients with biliary diseases.

Figure 4 Therapeutic outcomes in the surgical and non-surgical groups.