老年胆道外科疾病手术适应证与时机问题

The problems of indication and timing of operation for surgical biliary tract diseases in elderly patients.

目的研究胆道疾病手术适应证和手术时机,减少术后并发症,降低死亡率。方法 160例60岁以上老年胆道疾病患者全部行外科手术治疗,择期手术87例(54.37%);急诊手术73例(45.63%)。术前伴随一种并存病88.75%(三种以上并存病20.63%)。结果术后并发症32.75%,死亡率6.25%,6例 ACST 术后死于 MODF,4例胆道肿瘤衰竭死亡。结论掌握手术的适应证和手术时机.处理并存病,争取择期手术,避免急诊手术盲目性是外科治疗老年胆道疾病,减少并发症,降低死亡率的关键。

Objective To study indication and timing of operation in elderly patients with biliary disease in order to decrease postoperative complication and lower mortality.Methods Altogether 160 patients over 60 years old with biliary disease were operated on,including 87 cases subjected to elective surgery(54.37%)and 73 cases(45.63%)to emergency surgery.The patients had preoperatively con- comitant one kind of disease in 88.75%,and three kinds of diseases in 20.63%.Results Postopera- tive complication occurred in 23.75% patients and mortality in 6.25%(6 cases of ACST died of MOF and 4 cases,of biliary tract malignant failure).Conclusions The important factors to decrease the post- operative complication and mortality in treatment of biliary tract diseases in elderly patients are master- ing the operative indication and timing,treating concomitant diseases,striving for elective surgery,and to avoid unreasonable operation.