高龄病人胆道手术137例临床分析

Biliary tract surgery in the elderly:a clinical analysis of 137 cases

目的探讨高龄病人胆道手术的围手术期处理和手术时机选择。方法回顾分析温州医学院附属第一医院1998年12月至2007年9月外科手术治疗的137例80岁以上的胆道疾患临床资料。其中入院48h内急诊手术38例,一般状况好转后1周内早期手术36例;择期手术63例。结果急诊组术前有并存疾病者17例,术后出现并发症者12例,死亡1例;早期组有并存疾病者17例,术后出现并发症者12例,死亡1例;择期组有并存疾病者33例,术后有并发症者15例,无死亡结论积极处理并存疾病,加强围手术期处理是改善胆道疾病高龄病人手术治疗预后的关键。

Objective To study the perioperative management and proper time of biliary tract surgery in elderly.Methods Data of 137 senile patients(>80 years of age) who underwent biliary tract surgery from 1998 to 2007 were analyzed retrospectively.Among them,38 cases were operated within 48 hours(Group A),36 cases were operated within1 week after the general state of the patients became better(Group B).The rest 63 cases from out-patient department were underwent selective operation(Group C).Results In Group A,there were 17 cases with concomitant diseases and12 cases with postoperative complications,1 patient died In Group B,there were 17 cases with concomitant diseases and12 cases with postoperative complications,1 patient died.In Group C,there were 33 cases with concomitant diseases and15 cases with postoperative complications,without patient died.Conclusion To improve the prognosis of biliary tract srugery in the elderly,the keys are to deal with the concomitant diseases actively and strengthen the perioperative management.