M Brazkiewicz, Javed Latif, Robyn Anderson, Imran Bhatti, Altaf Awan Awan
ABSTRACT Background Laparoscopic common bile duct exploration (LCBDE) treats choledocholithiasis whilst avoiding morbidity associated with endoscopic retrograde cholangiopancreatography (ERCP). This study compared outcomes of LCBDE in patients aged < 70 years and ≥ 70 years at a high‐volume specialist center. Methods A retrospective analysis of a prospectively maintained database was performed for patients undergoing LCBDE between January 2011 and September 2024. Patients were stratified by age (< 70 vs. ≥ 70 years). Primary outcome was complete bile duct clearance. Secondary outcomes included operative time, length of stay (LOS), 30‐day morbidity (Clavien–Dindo), conversion to open surgery, readmission, and retained stones. Statistical analyses used Mann–Whitney U and χ 2 or Fisher's exact tests. Results Four hundred and ninety‐four patients underwent LCBDE (375 < 70 years; 119 ≥ 70 years). Elderly patients had higher ASA grades and Charlson Comorbidity Index scores ( p < 0.001). Complete ductal clearance was achieved in 99.5% of younger and 100% of elderly patients ( p = 0.20). Conversion to open surgery occurred in six patients. No perioperative mortality was observed. Median LOS was longer in elderly patients (3 vs. 2 days; p < 0.001). Thirty‐day morbidity did not differ significantly between groups. Conclusion LCBDE is a safe and effective treatment for choledocholithiasis in selected elderly patients when performed in specialist centers.