高龄患者胆石症急性发作的处理分析

The analysis of dealing with acute paroxysm of cholelithiasis in elder patients

目的:探讨提高高龄患者胆石症急性发作的治疗。方法:回顾总结了1995年5月～2003年10月间收治的57例高龄患者胆石症急性发作的诊治资料。结果:57例中3例“胆囊结石嵌顿”行保守治疗,成功2例,中转手术1例。其余54例中行“胆囊切除或次全切除+残端造瘘,胆总管切开,T管引流术”;1例因感染中毒性休克术中死亡,3例因术后并发症死亡。共治愈53例。结论:高龄患者胆石症急性发作后,及时确诊,选择合理的治疗方案,积极有效的抗感染是提高治愈率的关键。

Objective To explore how to improve the treatment of cholelithiasis paroxysm in elder patients.Methods To analyse the data of 57 older inpatients with cholelithiasis paroxysm from May 1995 to October 2003 retrospectively.Results 3 of 57 patients were embedded with gall-stones,2 of them were cured by conservative treatments ,1 was cured by laparotomy.The others, total 54 , were treated with cholecystectomy , sub-cholecystectomy combined stump fistulization, common bile duct incision and exploration ,and bile duct drainage. Among them, 1 died for heart and lung functional failure during the operation due to the existed infectious sepsis shock . 3 died for post-operational complications.Totally 53 were cured. Conclusion The key of treating acute paroxysm of cholelithiasis in elder patients needs in-time diagnosis ,reasonable therapeutic plans, functional and efficient anti-infectious treatments.