老年结石性胆囊炎急性发作时腹腔镜54例分析

Analysis of 54 Cases Elderly Calculous Cholecystitis Acute Attack Treated with Laparoscopic Surgery

目的:探讨腹腔镜胆囊切除术(LC)在老年结石性胆囊炎急性发作时的时机和方法。方法:搜集笔者所在科54例急性发作的老年结石性胆囊炎LC病例并对其进行归纳整理。将全组病例分为两组:早期组(发病时间均在72h以内),延期组(发病时间均大于72h),并对这两组的治疗效果进行比照,结果:腹腔镜胆囊切除术(LC)全部成功,均未出现严重并发症。但延期组的平均围手术期时长、平均手术时长、平均术后住院日和平均术后下床活动时间都比较长。结论:老年结石性胆囊炎在急性发作早期行腹腔镜胆囊切除术是安全的,延期施行腹腔镜胆囊切除术时要极为谨慎。

Objective:To investigate the timing and method of the laparoscopic cholecystectomy(LC) in elderly calculous cholecystitis acute attack. Methods:To collect our department 54 cases of acute exacerbation of elderly cholecystitis LC cases and to summarize them.All the patients were divided into two groups:the early group(time of onset within 72 hours),the extension group(time of onset were greater than 72 hours).The effect of two groups was compared. Results:The whole group of laparoscopic cholecystectomy (LC) was successful in all,the whole group was not serious complications,but the average perioperative time,mean operative duration,the average postoperative length of stay and average postoperative ambulation time in the early group were longer than which in the extension group.Conclusion:Senile cholecystitis acute onset of early laparoscopic cholecystectomy is safe laparoscopic extension,it should to be extremely cautious when the capsule resection.