Risk factors for bile leakage after laparoscopic common bile duct exploration in older patients with choledocholithiasis

Table 1 Demographic data and clinical characteristics of older patients with common bile duct stones

Characteristic	Non-bile leakage	Bile leakage	P value
Sex
Male	26	5	1.000
Female	32	7	-
Age (years), mean ± SD	77.10 ± 5.483	79.09 ± 6.788	0.278
Diabetes mellitus
Yes	10	5	0.136
No	48	7	-
Hypertension
Yes	33	9	0.400
No	25	3	-
Pulmonary disease
Yes	16	6	0.128
No	42	6	-
Heart disease
Yes	9	3	0.709
No	49	9	-
Cerebrovascular disease
Yes	9	3	0.709
No	49	9	-
ASA score
II	44	9	0.433
III	13	2	-
IV	1	1	-

ASA: American Society of Anesthesiologists.

Table 2 Analysis of factors related to bile leakage after laparoscopic common bile duct exploration

Characteristic	Non-bile leakage	Bile leakage	P value
Sex
Male	26	5	1.000
Female	32	7	-
Age (years), mean ± SD	77.10 ± 5.483	79.09 ± 6.788	0.278
Viral hepatitis B
Yes	2	1	1.000
No	56	11	-
Diabetes mellitus
Yes	10	5	0.136
No	48	7	-
Hypertension
Yes	33	9	0.400
No	25	3	-
White blood cell count
< 10 × 109/L	51	12	0.343
≥ 10 × 109/L	7	0	-
Percentage of neutrophils
< 70%	32	7	1.000
≥ 70%	26	5	-
Hemoglobin
< 120 g/L	31	9	0.292
≥ 120 g/L	27	3	-
Total bilirubin
< 34.2 μmol/L	41	6	0.165
≥ 34.2 μmol/L	17	6	-
Direct bilirubin
< 17.1 μmol/L	39	6	0.256
≥ 17.1 μmol/L	19	6	-
Indirect bilirubin
< 17.1 μmol/L	43	9	1.000
≥ 17.1 μmol/L	15	3	-
Alanine transaminase
< 80 U/L	29	8	0.462
≥ 80 U/L	29	4	-
Aspartate aminotransferase
< 70 U/L	39	8	1.000
≥ 70 U/L	19	4	-
Alkaline phosphatase
< 100 U/L	12	2	1.000
≥ 100 U/L	46	10	-
γ-glutamyl transpeptidase
< 45 U/L	5	2	0.751
≥ 45 U/L	53	10	-
Total bile acid
< 13 μmol/L	38	6	0.311
≥ 13 μmol/L	20	6	-
Total cholesterol1
< 5.7 mmol/L	49	12	0.341
≥ 5.7 mmol/L	9	0	-
High-density lipoprotein cholesterol1
< 1.55 mmol/L	45	11	0.476
≥ 1.55 mmol/L	13	1	-
Low-density lipoprotein cholesterol1
< 3.36 mmol/L	46	11	0.552
≥ 3.36 mmol/L	12	1	-
Amylase
< 133 U/L	50	10	1.000
≥ 133 U/L	8	2	-
Total protein
< 65 g/L	36	9	0.603
≥ 65 g/L	22	3	-
Albumin
< 35 g/L	28	6	0.913
≥ 35 g/L	30	6	-
Associated cholecystectomy
Yes	57	12	1.000
No	1	0	-
Stone position
Upper	11	4	0.473
Lower ends	47	8	-
Number of stones
≤ 1	23	4	0.933
> 1	35	8	-
Stone size
< 10 mm	15	5	0.452
≥ 10 mm	43	7	-
Diameter of CBDSs
< 10 mm	6	2	0.898
≥ 10 mm	52	10	-
Operation mode
PDC	32	4	0.345
T-tube drainage	21	7	-
PDC + ENBD	5	1	-
Abdominal surgery history
Yes	14	4	0.764
No	44	8	-
Periampullary diverticula
Yes	4	2	0.593
No	54	10	-
Postoperative fasting time
≤ 1 day	33	9	0.400
> 1 day	25	3	-
Bacterial culture of bile1
Negative	26	1	< 0.05
Positive	32	11	-

¹Missing data are marked.

CBDSs: Common bile duct stones; ENBD: Endoscopic nasobiliary drainage; PDC: Primary duct closure.

Table 3 Distribution of bile bacteria after laparoscopic common bile duct exploration in older patients with common bile duct stones

Bile bacteria	Non-bile leakage	Bile leakage
Enterococcus faecalis	3	4
Escherichia coli	5	1
Enterococcus faecium	4	1
Klebsiella pneumoniae	2	2
Enterococcus gallinarum	3	1
Enterobacter cloacae	2	1
Pseudomonas aeruginosa	0	2
Aeromonas caviae	0	1
Staphylococcus aureus	1	0
Staphylococcus hemolyticus	1	0
Actinomyces israeli	1	0
Enterococcus hirae	0	1
Morganella morganii	1	0
Klebsiella oxytoca	1	0
Polymicrobial	5	3

Table 4 Effect of different bile culture bacterial types on bile leakage in older patients with common bile duct stones after laparoscopic common bile duct exploration

Bacteria	Non-bile leakage	Bile leakage	P value	Logistic regression analysis (P value, OR, 95%CI)
Enterococcus faecalis
Yes	3	4	< 0.05	< 0.05, 7.857, 1.321-46.438
No	53	7	-	-
Escherichia coli
Yes	5	1	1.000	-
No	43	10	-	-
Enterococcus faecium
Yes	4	1	1.000	-
No	44	10	-	-
Klebsiella pneumoniae
Yes	2	2	0.316	-
No	46	9	-	-
Enterococcus gallinarum
Yes	3	1	1.000	-
No	45	10	-	-
Pseudomonas aeruginosa1
Yes	0	2	< 0.05	NA, NA, NA
No	48	9	-	-
Aeromonas caviae
Yes	0	1	0.186	-
No	48	10	-	-
Monomicrobia	41	8	0.356	-
Polymicrobial	5	3	-	-

¹Test not performed due to few events and no events in one arm.

NA: Not available; OR: Odds ratio; CI: Confidence interval.