腹腔镜手术治疗老年人胆囊并胆管结石 (附75例报告)

目的探讨腹腔镜手术治疗老年人胆囊并胆管结石的可行性及疗效。方法回顾性分析2001年1月～2005年12月腹腔镜手术治疗60岁以上老年人胆囊并胆管结石75例资料。结果72例手术成功,3例中转开腹,手术时间60～270min,胆总管T管引流42例,一期缝合30例;术后有3例发生胆漏,经保守治疗治愈;6例有肝内残余结石,于术后1.5个月经T管窦道取净结石。结论作好充分的围手术期处理,择期的腹腔镜手术治疗老年人胆囊并胆管结石安全、可行,但需娴熟的腹腔镜操作技术。在老年人中严格掌握好适应证胆总管一期缝合亦是安全、可行的。

Laparoscopic treatment of both gallbladder and bile duct stones in elderly patients (75 cases report)

Objective] To study the feasibility and the curative effect of laparoscopic treatment of both gallbladder and bile duet stones in elderly patients. Methods] A retrospective study was adopted to analyze the therapeutic scheme and effect for elderly patients of over 60 years old with gallder stones and bile duet stones who were treated from Jan 2001 to Dec 2005. Results] 72 cases were successfully performed with laparoscopic operation. 3 cases underwent conversion to open surgery. The time of operation was 60-270 min. T-tube was placed in 42 cases, primary suture in 30 cases, bile leak occurred in 3 eases and were cured with conservative treatment, 6 cases had retained stones in intrahepatic bile duet and were clearanced with choledochscopy after 1.5 months. Conclusions] It is safe and effective that laparoscopic operation treats both gallbladder and bile duet stones in elderly patients in skilled hands. Grasping indication, primary suture is also safe and feasible in elderly patients