老年患者腹腔镜胆囊切除术412例

Laparoscopic cholecystectomy in elderly patients:A report of 412 cases

目的探讨老年患者腹腔镜胆囊切除术（lapamscopic cholecystectang LC）的特点。方法回顾性分析1998年1月-2008年1月我院收治的412例老年患者的临床资料。结果402例顺利实施LC，中转开腹手术10例，其中7例胆囊三角粘连严重，2例术中出血量较大且难以控制，另1例为胆总管损伤。3例术后出现胆漏，2例经保守治疗，1例经腹腔镜再次探查术后均治愈。LC时间30～122min（平均50min），所有患者术后均痊愈出院。术后随访6—12个月（平均9月），无腹痛、发热、黄疸等并发症。结论在必要的围手术期处理、严谨的手术操作的前提下，老年患者行Lc是安全、可行的。

Objective To investigate the characteristics of laparoscopic cholecystectomy（LC） in the elderly patients. Methods A retrospective analysis was made on clinic data of 412 elderly patients treated by LC in this hospitial between January 1998 and January 2008. Results The LC was successfully performed in 402 patients, the other 10 patients were converted to open surgery because of massive adhesion at the Calot＇ s triangle （7 cases）, uncontrollable wound hemorrhage （ 2 cases） and common bile duct injury （ 1 patients）. Bile leakage occurred in 3 cases,2 cases underwent conservative treatment, 1 case received exploratory laparoscopy. The operation time lasted 30 - 122 min（ mean ,50min）. The postoperative recovery was uneventful in all the patients. No postoperative abdominal pain or fever occurred in the recent following up. Conclusions Laparoscopic cholecystectomy is acceptable and safe for the elderly patients. Proper preoperative management and careful surgical performance are essential to the success of surgery.