老年人腹腔镜胆囊切除术的围手术期处理

Perioperative management of laparoscopic cholecystectomy in the elderly

目的探讨老年人腹腔镜胆囊切除术围手术期处理方法。方法回顾性分析我院2000年9月-2007年11月对760例老年胆囊疾病病人行腹腔镜胆囊切除术的临床资料。结果本组有748例成功实施了腹腔镜胆囊切除术，有12例因炎性粘连或机械故障等原因中转开腹。腹腔镜手术时间为30-100min，平均40min。术中平均出血量为20ml。发生手术后并发症11例。术后平均住院时间4d。结论只要重视围手术期的处理，对老年病人也可以安全地施行腹腔镜胆囊切除术。

Objective To investigate the experience in the management of laparoscopic cholecys- tectomy（LC） in the elderly with gallbladder diseases. Methods Seven hundred and sixty elderly patients admitted from Sep. 2000 to Nov. 2007 underwent laparoscopic exploration with intention of cholecystectomy for gallbladder diseases in our hospital, and the clinical data of these patients were analyzed retrospectively. Results LC was successfully performed on 748 cases, and the other 12 cases were converted to open surgery because of dense inflammatory adhesion or instrument problems; the operating time was 30 to 100 min（mean 40 min） ; the average blood loss was 20 ml; postoperative morbidities occurred in 14 cases;the average postoperative hospital stay was 4 days. Conclusion With the proper perioperative management and technique refinement, LC is a safe surgical operation in selective elder patients.