老年人腹腔镜胆囊切除术的应用体会

Experience of laparoscopic cholecystectomy in 58 cases of elderly patients

目的结合老年人胆囊腹腔镜胆囊切除术的临床特点及经验,并探讨预防和减少并发症的方法。方法总结应用老年人腹腔镜行胆囊切除术58例的实践。结果在全麻和CO2气腹状态下,老年人58例行LC手术,中转开腹2例,1例出现胆总管损伤,无出血等其他严重并发症,无死亡病例。结论从老年人生理特点方面分析,有胆囊切除指征者LC是首选治疗方法,而术前充分准备,术中严密观察,及时中转开腹,是预防和减少并发症的关键。

[Objective] To summarize the experience and clinical character of laparoscopic cholecystectomy（LC） in elderly patients, and discuss how to prevent and reduce complications. [Methods] To summarize the experience of 58 cases of elderly patients received LC. [Result] Under general anaesthesia and CO2 pneumoper toneum. 2 cases of them were converted to open surgery. Common bile duct was injuried in one case. The success rate of LC was 96.5%, no bleed or other severity complications observed, no death occurred [Conclusions] Analysising elderly patients physiological feature, LC is the first choice in elderly patients who have cholecystectomy indication. Careful perioperative management.and intensive observation intraoperation and converting to open suegery timely are key points to prevent and reduce complications with LC.