腹腔镜胆总管切开取石在老年胆道结石患者中的应用

Laparoscopic common bile duct exploration in elderly patients with biliary calculi

目的探讨腹腔镜胆总管切开取石治疗老年胆道结石患者的有效性,安全性。方法从2007年4月至2011年12月本院共行86例腹腔镜胆总管切开取石术。将这些患者按年龄分为两组,并进行回顾性分析。老年组(≥70岁)40例,年轻组(<70岁)46例。对比两组临床特点,手术时间,住院时间,中转开放手术率,术后累计并发症发生率,残石率和死亡率。结果老年组表现出较高的麻醉评分(P=0.003)及基础疾病患病率(P<0.01),而平均手术时间,术后住院时间,中转开放手术率,残石率,并发症的发生率、死亡率,两组无显著性差异(P>0.05)。结论腹腔镜胆总管切开取石不仅对年轻胆总管结石患者安全有效,对老年患者也是一种安全有效的治疗方式。

Objective To evaluate the efficacy, safety of laparoscopic common bile duct exploration in patients who are 70 years or older. Methods From April 2007 to December 2011, 86 patients underwent LCBDE. We divided these patients into two groups according to age and conducted a retrospective analysis. The elderly group included patients who were 70 years old or older （ n = 40）, and the younger group included those who were younger than 70 （ n = 46）. The elderly group was compared to the younger group with respect to their clinical characteristics, operation time, postoperative hospital stay, open conversion rate, postoperative complica- tion, Residual stone rate and mortality. Results The elderly group showed high American Society of Anesthesiologists score （ P = O. 003 ） and complications rate （P 〈 O. 001 ）. There were no significant differences in mean operation time, postoperative hospital stay, remnant stone, complication rates or mortality in both groups （ P 〉 0. 05）. Conclusion Laparoscopic common bile duct exploration is a safe and effective treatment modality for CBD stones not only for younger patients but also for elderly patients.