腹腔镜胆囊切除术治疗老年人急性胆囊炎疗效观察

目的探讨适时腹腔镜胆囊切除术(LC)在老年人急性胆囊炎的应用价值。方法按发病至手术时间,随机将68例患者分为2组。A组为早期LC手术组,38例,起病72 h以内行LC;B组系开腹手术组,30例,起病72 h内行开腹胆囊切除术。两组手术用时、肠蠕动恢复时间、术后住院时间及并发症发生率。结果A组的手术时间、肠蠕动恢复时间以及术后住院时间均短于B组;A组术后7例发生手术并发症,B组术后8例发生手术并发症,经χ2检验,两组差异无统计学意义。结论急性胆囊炎起病72 h以内,老年行LC是相对安全的。综合评估术前全身机能状况、合理选择手术时机、术中细致操作以及适时中转开腹是安全实施LC和减少并发症的关键。

The Application of Laparoscopic Cholecystectomy at the Right Moment for the Aged Patients with Acute Cholecystitis

Objective To explore the value of laparoscopic cholecystectomy(LC) at the right moment for the aged acute cholecystitis.Methods According to the time from cholecystalgia beginning to operation,there were 68 cases of aged acute cholecystitis who were divided by random lot into 2 groups,38 cases(LC group) were given LC less than 72 hours from cholecystalgia beginning and 30 cases(routine cholecystectomy) were given roution cholecystectomy.The duration of operation,recovery time of intestinal tract,the time of hospitalization and complications after operation were investigated.Results The duration of operation,recovery time of intestinal tract,the time of hospitalization after LC were shorter than that of routine cholecystectomy.There were 7 cases happened complications in LC group and 8 cases in routine cholecystectomy,and by X2-test,there was no statistics difference.Conclusions LC is safe for the aged acute cholecystitis in 72 hours from cholecystalgia beginning.The key steps to reduce complications are wholely appraising systematic condition,choosing operation juncture rationally,manipulating carefully during operating and transferring to routine cholecystectomy when necessary.