老年人不同时期行腹腔镜胆囊切除术的临床分析

目的探讨老年人不同时期行腹腔镜胆囊切除术（LC）的安全性及临床疗效。方法对本院2009年1月～2013年12月收治的151例行LC治疗老年人的临床资料进行回顾性分析。根据手术时期的差异，将患者分为三组，A组为非急性期手术，B组为胆囊炎急性发作72h内手术，C组为发病72h后手术，比较三组的手术时间、术中出血量、术后住院时间、中转开腹率、置管引流率及术后并发症发生率。结果A组与B组的手术时间、术中出血量、中转开腹率、术后并发症发生率及术后住院时间比较差异无统计学意义（P〉O．05）；C组的手术时间、术后住院时间长于A组和B组，术中出血量多于A组和B组，中转开腹率、置管引流率、术后并发症发生率高于A组和B组，差异有统计学意义（P〈0．05）。结论老年人行LC选择非急性期和急性发作72h内手术是安全、可行的。

Clinical analysis of laparoscopic cholecystectomy for the elderly in different period

Objective To discuss the clinical efficacy and safety of laparoscopic cholecystectomy for the elderly in dif- ferent period. Methods The data of 151 cases of elderly patients treated with laparoscopic cholecystectomy were retrospectively analyzed from January 2009 to December 2013.Patients were divided into there groups according to the difference of operation period.Laparoscopic cholecystectomy in non acute phase was used in group A,laparoscopic cholecystectomy within 72 hours of acute cholecystitis was used in group B,laparoscopic eholecystectomy after 72 hours of acute eholeeystitis was used in group C.The operation time,intraoperative blood loss,postoperative hospital stay,open conversion rate,drainage rate and postoperative complication rate of three groups was compared respectively. Results The operation time,intraoperative blood loss,open conversion rate,postoperative complication rate and postoperative hospital stay between group A and group B was compared respectively,with no statistical difference （P〉0.05）.The operation time and postoperative hospital stay in group C was longer than that in group A and group B respectively,intraoperative blood loss in group C was more than that in group A and group B respectively,open conversion rate,drainage rate and postoperative complication rate in group C was higher than that in group A and group B respectively,with statistical difference （P〈0.05）. Conclusion Laparoscopic choleeystectomy is a safe and feasible technique in non acute phase and acute cholecystitis within 72 hours in the elderly patients.