腹腔镜胆囊切除术在老年急性坏疽性胆囊炎中的应用

目的探讨腹腔镜胆囊切除术在老年急性坏疽性胆囊炎的可行性和优势。方法选择该院治疗急性坏疽性胆囊炎的62例老年患者，随机分成两组。腹腔镜组31例，开腹组31例，比较两组患者情况。结果31例腹腔镜组患者中30例成功完成腹腔镜胆囊大部切除术，1例中转开腹切除。腹腔镜组的手术时间、术中出血量、引流管拔除时间、住院天数均显著低于开腹组（P〈0．05）；腹腔镜总并发症数明显少于开腹组（P〈0．05）。结论腹腔镜急性坏疽性胆囊炎胆囊切除术具有手术创伤小，创口恢复较好，患者术后痛苦小的特点，是安全、有效的方法。

Feasibility on the treatment of acute gangrenous cholecystitis in elderly by laparoscopy cholecystectomy and its advantage

Objective To investigate feasibility on the treatment of acute gangrenous cholecystitis in elderly by laparoscopy cholecystec- tomy and its advantage. Methods Sixty-two elderly patients with acute gangrenous cholecystitis in two hospitals were randomly divided into two groups, laparoscopic group （ n = 31 ）, laparotomy group （ n = 31 ）. The situations of two groups were compared. Results 30 cases of 31 laparoscopic group patients successfully completed laparoscopic subtotal gastrectomy, 1 case converted to laparotom~; resection. Op- erative time, intraoperative blood loss, drainage tube removed time, hospital stay in laparoscopic group were significantly lower than those in laparotomy group（P 〈 O. 05 ）. The number of total complications in laparoscopic group was significantly lower than that in lapa- rotomy group （ P 〈 O. 05 ）. Conclusions The treatment of acute gangrenous choleeystitis by laparoscopy cholecystectomy has the characteristics of small surgical trauma,good wound recovery,and less pain after surgery. It is a safe and effective method.