腹腔镜胆囊切除术在老年急性化脓性胆囊炎的临床应用

Clinical application of laparoscopic cholecystectomy for elder patients with acute suppurative cholecystitis

目的评估腹腔镜胆囊切除术在老年急性化脓性胆囊炎患者中的可行性和安全性。方法回顾性分析年龄>60岁的286例老年急性胆囊炎患者的临床资料。结果 286例老年急性化脓性胆囊炎患者中,267例行腹腔镜胆囊切除术,18例因胆囊三角解剖关系不清行胆囊造瘘或胆囊大部分切除术,1例中转开腹,无1例死亡。手术时间平均为(84.68±29.18)min,术中出血量平均为(83.56±43.10)mL,平均住院时间为(9.25±3.07)d。术后随访6个月,无黄疸、腹痛、发热等并发症。结论对老年急性化脓性胆囊炎患者实施腹腔镜胆囊切除术是安全、可行的,值得在临床上推广。

Objective To evaluate the feasibility and safety of laparoscopic cholecystectomy(LC)for elder patients(age>60 years)with acute suppurative cholecystitis(ASC).Methods The clinical data of 286 elder patients with acute suppurative cholecystitis were extracted and analyzed.Results Of 285 patients undergoing total laparoscopic surgery,267 patients received LC and the other 18 patients had cholecystostomy or subtotal cholecystectomy.Conversion occurred in only 1 patient and all 286 patients survived.The mean operative time,intraoperative blood loss,and hospital stay were(84.68±29.18)min,(83.56±43.10)mL,and(9.25±3.07)days,respectively.No jaundice,abdominal pain,fever or other complications occurred during the postoperative 6 months follow up period.Conclusion LC is safe and feasible for elder patients with ASC and should be performed extensively in clinical practice.