高龄患者腹腔镜胆总管探查T管引流术临床分析

Clinical analysis on laparoscopic common bile duct exploration and T-tube drainage for senile patients

目的:探讨腹腔镜胆总管探查T管引流术的围手术期处理措施及临床疗效。方法:回顾分析2007年1月至2012年6月为108例高龄患者行腹腔镜胆总管探查T管引流术的临床资料。结果:107例顺利完成腹腔镜手术,1例中转开腹,无一例死亡。手术时间45～123 min,平均(52±21)min;术中出血量40～110 ml,平均(58±23)ml。术后胆道残石1例,无胆漏、出血、胆道感染等严重并发症发生。住院5～10 d,平均(6.4±1.5)d。随访6～48个月,无胆道相关并发症发生。结论:掌握一定的手术技巧,积极围手术期处理,腹腔镜胆总管探查T管引流术对高龄患者是安全、可行的。

Objective： To discuss perioperative management as well as clinical efficacy of laparoscopie common bile duct explo- ration and T-tube drainage for senile patients. Methods：The clinical data of 108 senile patients who underwent laparoscopie common bile duct exploration and T-tube drainage between Jan. 2007 and Jun. 2012 were analyzed retrospectively. Results：Laparoscopic surgery was conducted successfully in 107 patients with one conversion to laparotomy. Residual stones occurred in one patient, and no death, bile leakage, hemorrhage or biliary tract infection occurred. The operation duration was 45-123 rain, mean （ 52 ~ 21 ） rain. The intraoper- ative blood loss was 40-110 ml, mean （ 58 ~ 23 ） ml. The hospital stay was 5-10 d, mean （ 6.4 1.5 ） d. No biliary tract associated com- plications occurred during a 6-48 months follow-up. Conclusions ： It is safe and feasible to execute laparoscopie common bile duct ex- ploration and T-tube drainage for senile patients when good operation technique and perioperative management are available.