腹腔镜联合胆道镜胆总管探查术治疗超高龄胆总管结石患者的安全性及有效性分析

Safety and efficacy of laparoscope combined with choledochoscope for common bile duct exploration in ultra-elderly patients with choledocholithiasis

目的:探讨腹腔镜联合胆道镜胆总管探查术治疗超高龄(≥80岁)胆总管结石患者的安全性及有效性。方法:回顾分析2013年1月至2018年12月行腹腔镜联合胆道镜胆总管探查术的83例胆总管结石患者的临床资料,根据年龄分为两组,≥80岁为超高年龄组(n=33),<80岁为低龄组(n=50),对比分析两组临床指标。结果:患者均成功治疗,顺利出院,无死亡病例。两组手术时间、术中出血量、中转开腹、T管夹闭时间、腹腔引流管拔除时间、转入ICU例数、术后并发症差异无统计学意义(P>0.05);超高年龄组在术后进食时间、下床活动时间、术后住院时间、住院费用方面高于低龄组,差异有统计学意义(P<0.05)。结论:腹腔镜联合胆道镜胆总管探查术治疗超高龄(≥80岁)胆总管结石患者是安全、有效的。

Objective:To explore the safety and efficacy of laparoscope combined with choledochoscope for common bile duct exploration in ultra-elderly(≥80 years)patients with choledocholithiasis.Methods:The clinical data of 83 patients with choledocholithiasis treated by laparoscope combined with choledochoscope for common bile duct exploration from Jan.2013 to Dec.2018 were retrospectively analyzed and compared.All these patients were divided into two groups according to the age,with 33 cases≥80 years old in the ultra-elderly group and 50 cases<80 years old in the younger group.Results:All patients were successfully treated and discharged smoothly without death.There were no statistical differences in the operation time,intraoperative blood loss,conversion to laparotomy,T-tube clamping time,removal of abdominal drainage tube time,the number of cases transferred into ICU and postoperative complications between the two group(P>0.05).There was a statistical increase in the ultra-elderly group in postoperative eating time,time to ambulation,postoperative hospital stay and hospitalization expenses compared with the younger group(P<0.05).Conclusions:Laparoscope combined with choledochoscope for common bile duct exploration in ultra-elderly(≥80)patients with choledocholithiasis is safe and effective.