老年腹腔镜胆囊切除术4128例

Laparoscopic cholecystectomy on elderly patients with gallstone

目的 研究老年人因胆囊良性病变行腹腔镜胆囊切除术 (LC)的临床特点 .方法 1992 0 2 / 2 0 0 1 12我院收治 6 0岁以上老年人LC4 12 8例 ,对临床资料进行回顾性分析 .结果 本组 4 12 8例中有 2 6 83例 (6 5 .0 0 % )合并有不同程度糖尿病或心血管疾病及支气管疾患 ,735例 (17.81% )粘连严重 ,操作难度大 ,4 6例 (1.11% )中转开腹 ,其余顺利完成LC ,其中胆管损伤 2例 ,胆漏 6例 ,胃肠道损伤 2例 ,出血 3例 ,手术后死亡 3例 ,其他一般性并发症 38例 (0 .92 % ) .结论 做好围手术期处理后 ,LC应为老年人胆囊切除的首选治疗方法 ,但合并病易导致术后死亡 。

AIM To investigate the clinical characteristics of laparoscopic cholecystectomy(LC)on elderly patients with gallstone. METHODS A retrospective analysis was made on the clinical data of 4128 patients with gallstone (age: over 60) who underwent LC at our hospital from February 1992 to December 2001. RESULTS Of the 4128 patients, 2683 (65.00%) also suffered from diabetes, cardiovascular diseases and/or bronchitis. During the operation, 735 among the 4128 patients(17.81%) had severe adhesion around gallbladder, which made it difficult to perform LC. 46 cases (1.11%) turned to laparotomy whereas other patients were operated on successfully without serious complications. Of the 46 cases that underwent laparotomy, 2 got injured in their bile duct, 6 had biliary fistula, 2 had gastroenteric injury, 3 had hemorrhage, and 3 died. The other 38 cases (0.92%) had some general complications. CONCLUSION Thus we conclude that LC is an optimal treatment for elderly patients with gallstone. Of course, caution has to be taken against complications which can be highly fatal after operation.