184例高龄胆道疾病围手术期治疗体会

Experience of perioperative management in aged patients with biliary tract diseases

目的探讨70岁以上老年胆道疾病围手术期处理方法及疗效。方法对1998年1月￣2003年12月该科收治的184例70岁以上老年胆道疾病患者的临床资料进行回顾性分析。结果该组有并存病135例,占73%,手术治疗162例,其中急诊手术58例,择期手术104例。手术方式:行胆囊切除术138例,胆囊切除及胆总管探查24例。术后发生并发症40例,占21%,非手术治疗22例,总死亡率为3.3%。结论70岁以上老年胆道疾病患者并存病多,术前应尽量详细了解病情,处理并发症,掌握适当的手术时机及合理的手术方式,是十分重要的,有利于提高手术成功率,降低并发症率和死亡率。

[Objective] To explore the perioperative mangement in aged patients with biliary tract disease. [Methods] To retrospectively analyze clinical data of 184 aged patients over 70 years with biliary tract diseases, who admitted to our hospital from January 1998 to December 2003. [Results] 135 cases （73%） of 184 aged patients had coexistent diseases. 162 patients were operated including 58 cases （36%） subjected to emergency surgery and 104（64%） cases to elective surgery. Cholecystectomy was performed in 138 cases, cholecystectomy and choledochostomy in 24 eases. Postoperative complication occurred in 40 cases （21%）. 22 patients were not opereated. The mortality rate was 3.9%. [Conclusion] The aged patients have more coexistent diseases. The important factors to decrease the postoperative complication and mortality are to treat coexistent diseases, to master the operative methods and time.