高龄患者腹腔镜胆囊切除术91例临床分析

Laparoscopic cholecystectomy in patients over 60:A report of 91 cases

目的:探讨腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)治疗高龄患者胆囊良性疾病的价值。方法:对91例60～80岁患者行LC,有合并症者41例。气管插管静脉复合全身麻醉,四孔法操作,CO2气腹压8～10mmHg。结果:85例LC成功,6例中转开腹,术后并发症发生率9例。结论:做好围手术期处理,控制好合并症,尽量缩短手术时间,LC对高龄患者是安全可行的。

Objective：To explore the feasibility of laparoscopic cholecystectomy （LC） in patients over 60 years old.Methods：The study was based on a retrospective view of chnical date in 91 aged patients （60-80 years old） who had been treated from October 2006 to August 2007 in this hospital,co-morbidities existed in 41 patients. The operation was performed under general anesthesia and endotra- chal intubation by using 4-port technique,and the CO2 pneumoperitoneum pressure was set at 8-10mmHg. Results：The LC was successfully completed in 85 patiens, while conversion to open surgery was required in 6 patients（6.6%）.The causes of conversion included severe intraperitoneal adhesion in 5 Patients, and suspicion of gallbladder carcinoma in 1 patient. Postoperative complications occurred in 9 patients （9.9% ,9/91）. Of them,pulmonary infection was 3 patients,port-site infection 3 patients,effusion in the gallbladder bed in 2 patients, and ileus in 1 patient.Conclusion：Laparoscopic cholecystectomy is safe and feasible in aged patients.Proper perioperative management, careful prevention co-morbidities, and control of operation time as short as possible are important for senile patients.