老年急性胆囊炎腹腔镜胆囊切除的临床分析

Clinical analysis of laparoscopic cholecystectomy in elderly patients with acute cholecystitis

目的 探讨老年急性胆囊炎行腹腔镜胆囊切除术的时机和方法.方法 回顾分析2005年1月至2015年1月158例老年急性胆囊炎（合并/不合并胆囊结石）患者腹腔镜胆囊切除的临床资料.结果 154例成功完成腹腔镜胆囊切除术,手术时间（95±25） min,4例因calot三角出现致密粘连或Mirizzi综合征中转开腹手术.结论 老年人急性胆囊炎的病情进展快,手术难度大,风险高;要高度重视围手术期处理,把握手术时机和技巧,早期腹腔镜胆囊切除是安全可行的.

Objective To investigate the time and technique of laparoscopic cholecystectomy（LC） in elderly patients with acute cholecystitis.Methods The clinical data of 158 aged patients with acute cholecystitis underwent LC form May 2005 to May 2015 were analyzed retrospectively.Results A total of 154 patients were performed early LC successfully,the operation time was （95 ± 25） minutes,4 cases failed because of the pykno-conglutinstion or Mirizzi syndrome and accepted the open cholecystectomy.Conclusions Aged acute cholecystitis progresses rapidly and its operative difficulty and risk is higher.If more attention can be paid to perioperative managements and command operative time and technical skill,early LC for the patient is safe and feasible.