Therapeutic experience of 289 elderly patients with biliary diseases

Table 1 Comparison of age distribution in surgical and non-surgical groups, n (%)

Age (yr)	Surgical group	Non-surgical group	χ2	P value
60-69	75 (43.4)	25 (21.6)	23.376	0.000
70-79	64 (37.0)	42 (36.2)
80-89	30 (17.3)	45 (38.8)
90-99	4 (2.3)	3 (2.6)
≥ 100	0 (0.0)	1 (0.9)
Total	173 (100.0)	116 (100.0)

Table 2 Distribution of disease type in surgical and non-surgical groups, n (%)

Type of disease	Surgical group	Non-surgical group	χ2	P value
Gallbladder stones	133 (36.8)	66 (32.7)	0.308	0.016
Common bile duct stones	41 (11.4)	23 (11.4)
Hepatolithiasis	4 (1.1)	7 (3.5)
Chronic cholecystitis	36 (10.0)	14 (6.9)
Acute cholecystitis	92 (25.5)	67 (33.2)
Gallbladder polyps	8 (2.2)	0 (0.0)
Acute cholangitis	16 (4.4)	16 (7.9)
Biliary pancreatitis	15 (4.2)	3 (1.5)
Biliary tract tumors	12 (3.3)	3 (1.5)
Gallbladder carcinoma	4 (1.1)	3 (1.5)

A single patient may have 1-2 types of biliary diseases.

Table 3 Proportion of types of diseases in surgical and non-surgical groups, n (%)

Group	n	One type of disease	Two types of diseases	χ2	P value
Surgical	173	71 (41.0)	102 (59.0)	3.198	0.074
Non-surgical	60 (51.7)	56 (48.3)

Table 4 Distribution of coexisting diseases in surgical and non-surgical groups, n (%)

Type of coexisting disease	Surgical group	Non-surgical group	χ2	P value
Coronary heart disease	40 (14.7)	28 (13.5)	17.526	0.131
Atrial fibrillation	8 (2.9)	1 (0.5)
Hypertension	84 (30.8)	55 (26.4)
Diabetes	33 (12.1)	22 (10.6)
Renal insufficiency	1 (0.4)	5 (2.4)
Chronic bronchitis with emphysema	5 (1.8)	9 (4.3)
Portal hypertension	3 (1.1)	0 (0.0)
Pulmonary infection	7 (2.6)	10 (4.8)
Hypoalbuminemia	9 (3.3)	9 (4.3)
Anemia	8 (2.9)	5 (2.4)
Electrolyte disorder	21 (7.7)	21 (10.1)
Cerebral infarction	30 (11.0)	28 (13.5)
Hepatic insufficiency	24 (8.8)	15 (7.2)

A single patient may have 1-6 types of coexisting diseases.

Table 5 Comparison of laboratory test results at admission in surgical and non-surgical groups

Item	Surgical group, n = 173	Non-surgical group, n = 116	t	P value
Routine blood
WBC (× 109/L)	8.54 ± 4.77	10.41 ± 5.58	-3.054	0.002a
N%	71.94 ± 14.81	79.45 ± 13.55	-4.450	0.000a
Hb (g/L)	127.41 ± 20.44	121.00 ± 20.06	2.631	0.009a
hs-CRP (mg/L)	50.02 ± 76.60	52.48 ± 58.76	-0.288	0.774
Liver function
ALT (U/L)	70.17 ± 103.96	94.13 ± 139.50	-1.573	0.117
AST (U/L)	71.32 ± 115.81	105.00 ± 190.88	-1.696	0.092
TP (g/L)	62.65 ± 8.33	62.06 ± 8.94	-0.553	0.581
Alb (g/L)	36.59 ± 5.92	35.16 ± 5.75	2.030	0.043a
TB (μmol/L)	51.74 ± 103.87	34.33 ± 37.06	2.021	0.044a
DB (μmol/L)	21.99 ± 39.50	15.85 ± 23.37	1.659	0.098
Tumor marker
CA19-9 (U/mL)	340.19 ± 1317.16	896.95 ± 6346.89	-0.880	0.380
CEA (ng/mL)	2.76 ± 4.13	142.66 ± 1283.35	-1.005	0.318
Blood clotting function
APTT (s)	32.49 ± 5.20	32.59 ± 7.56	-0.124	0.901
PT (s)	11.61 ± 1.38	12.12 ± 1.54	-2.739	0.007a
INR	1.05 ± 0.13	1.09 ± 0.14	-2.318	0.021a
FIB (g/L)	3.63 ± 1.21	3.69 ± 0.90	-0.449	0.654

^aP < 0.05, surgical group vs non-surgical group. Alb: Albumin; ALT: Alanine aminotransferase; APTT: Activated partial thromboplastin time; AST: Aspartate aminotransferase; CA19-9: Carbohydrate antigen 19-9; CEA: Carcinoembryonic antigen; DB: Direct bilirubin; FIB: Fibrin; Hb: Hemoglobin; hs-CRP: High sensitivity C-reactive protein; INR: International normalized ratio; N%: Neutrophil percentage; PT: Prothrombin time; TB: Total bilirubin; TP: Total protein; WBC: White blood cell count.

Table 6 Surgical procedures in elderly patients with biliary diseases

Surgical procedure	n (%)
Pancreaticoduodenectomy	6 (3.5)
Radical resection of hilar cholangiocarcinoma	6 (3.5)
Radical resection of gallbladder carcinoma	4 (2.3)
Hepatectomy	4 (2.3)
Open cholecystectomy (OC)	6 (3.5)
OC + common bile duct exploration + T-tube	21 (12.1)
OC + transcystic common bile duct exploration	14 (8.1)
Laparoscopic cholecystectomy (LC)	105 (60.7)
LC + endoscopic sphincterotomy or endoscopic papillary balloon dilation	7 (4.0)
Total	173 (100.0)