老年患者急性胆囊炎腹腔镜胆囊切除术手术时机探讨

Timing of laparoscopic cholecystectomy for aged patients with acute cholecystitis

目的:探讨老年患者急性胆囊炎行腹腔镜胆囊切除术(LC)的手术时机。方法:回顾性分析2008年1月至2011年12月施行LC的102例年龄大于60岁的老年急性胆囊炎患者临床资料,依手术时间将患者分为3组,A组:发病3d内手术,B组:发病4～7d手术,C组:发病距手术时间7d以上。分析发病距手术时间的长短对中转开腹、手术并发症、术后住院时间的影响。结果:共102例急性胆囊炎患者行急症LC手术,其中A组患者47例,B组36例,C组19例。总的中转开腹率和并发症发生率分别为5.88%和10.78%,比较3组的中转开腹率和并发症发生率无区别,但早期手术患者的手术时间和术后住院时间明显缩短。结论:不论发病时间长短,老年患者急症LC手术治疗急性胆囊炎是安全可行的。

To study the timing of laparoscopic cholecystectomy （LC） for aged patients with acute cholecystitis. Methods：The clinical data of patients with acute cholecystitis aged over 60 admitted from January 2008 to December 2011 were retrospectively analyzed. They were treated by LC. All patients were divided into three groups according to the timing of surgery： group A within the first 3 d, group B between 4 and 7 d and group C 7 d or longer from the onset of symptoms. The impact of timing on the conversion rate, complication incidence and postoperative length of hospital stay was studied. Results：A total of 102 patients underwent laparoscopic cholecystectomy for acute cholecystitis, including 47 in group A, 36 in B, and 19 in C. The total conversion rate and complication incidence were 5.88% and 10.78% respectively. There was no significant difference in the conversion rate and complication incidence among three groups. Furthermore, the operation time and postoperative hospitalization were significantly reduced in patients undergoing early LC. Conclusions：Laparoscopic cholecystectomy for senile people with acute cholecystitis is safe and feasible, regardless of the time elapsed from the onset of symptoms.