70岁以上老年人胆道疾病的外科处理

目的探讨７０岁以上老年胆道疾病的外科治疗方法及效果。方法回顾性总结１９９２年１月～１９９７年１２月间１０３例７０岁以上老年人胆道疾病手术治疗情况。结果本组有合并症６４例，占６２１％。胆囊切除５４例，胆囊切除及胆总管探查３９例，胆肠内引流５例，左肝外叶切除、胆囊造瘘各１例。术后发生并发症２４例（２３３％），其中急诊手术组为４０％，择期手术组为１４７％。总死亡率３９％。结论虽然７０岁以上老年人合并症多，但在全面了解病情，充分术前准备后，适时进行手术治疗，并采取合适的手术方式，可提高手术成功率，降低并发症率和死亡率。

Surgical management of biliary tract disease in patients aged over 70 years

Objective To study the method and effect of the surgical management for biliary tract disease in patients aged over 70 years. Methods Analysis of the clinic data of 103 patients aged over 70 years with biliary tract disease who admitted to our hospital from January 1992 to December 1997. Results Cholecystectomy was performed in 54 cases, cholecystectomy and choledochostomy in 39 cases, internal biliary drainage in 5 cases. Various underlying diseases were found in 64 cases. The morbidity rate was 23.3% (40% in emergency group, 14.7% in elective group). The mortality rate was 3.9%. Conclusions Prompt surgical intervention should be performed for biliary tract disease in patients aged over 70 years. However, carefully preoperative assessment and management are very important.