老年急性胆囊炎开腹胆囊切除与腹腔镜胆囊切除术的比较

Comparison of Elderly Patients with Acute Cholecystitis Treated by Open Cholecystectomy and Laparoscopic Cholecystectomy

目的研究老年急性胆囊炎患者的手术方式。方法 100例老年(年龄≥60岁)急性胆囊炎患者的临床资料,根据手术方式分为开腹胆囊切除组(OC组,n=50)和腹腔镜胆囊切除组(LC组,n=50例)。比较两组患者手术时间、术中出血量、术后进食时间、肠道功能恢复时间、住院时间及并发症情况。结果 LC组手术时间、术后胃肠功能恢复时间、住院时间、下床活动时间均低于OC组(t=2.782,t=2.845,t=2.811,t=2.914,P<0.05);OC组术后并发症20.0%,高于LC组8.0%(χ2=3.794,P<0.05)。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 study the suitable operation method of elderly patients with acute cholecystitis. Methods 100 elderly patients with acute cholecystitis were retrospectively analyzed. All patients were divided into two groups according to the operation： open cholecysteetorny group （OC group, n=50） and laparoscopic cholecystectomy group （LC group, n=50）. Some clinical data were compared in this paper such as operation time, blood loss, length of hospital stay, time of resumption of food, time of intestinal function recovery and complications. Results The time operative, gastrointestinal function recovery, hospitalization, get out of bed, in LC group were lower than the OC group（t=2.782, t=2.845, t=2.811, t=2.914, P〈0.05）; The complications of 20.0% in OC group were higher than the LC group 8.0% （χ^2 = 3.794, P〈0.05）. 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.