老年胆石症的临床特点和治疗

目的:总结老人胆石症伴感染的外科手术治疗经验.方法:回顾性分析136例手术病人.结果:手术治疗老年胆石症急性发作136例,治愈118例(治愈率86.7%),死亡4例(病死率3.85%).胆囊切除65例,胆囊切除加胆管探查取石36例,胆总管探查取石25例,胆总管节开引流7例,胆囊造瘘3例.结论:老年胆石症临床表现不典型,内科杂症多,易发生胆囊穿孔及急性梗阻性化脓性胆管炎等并发症.年龄不是手术禁忌,在积极进行围手术期处理基础上,把握手术适应症和手术时机,采用简单有效的术式,外科手术治疗高龄胆石症可以取得满意的疗效.

The clinical characteristics and strategies of treatment in the elderly patients with cholelithiasis

Objective:To evaluate the experience in the surgical treatment of the elderly patients with cholelithiasis.Methods:136 patients with cholelithiasis were retrospectively studied.Results:All patients underwent opertion.118 cases recurred(86.7%),and 4 cases died(3.85%).65 cases underwent cholecystectomy,while 36 cases underwent cholecystectomy plus exploration of common bile duct.25 cases were performed with exploration of common bile duct,and 7 cases underwent choledochostomy plus drain.In addition,3 cases underwent cholecystostomy.Conclusion:The characteristics are atypical manifestation,predispose to delay the diagnosis,more associasion with chronic disease.However,the age is no contraindication of operation.The satisfactory results can be achieved granted the indication and time for the operation are selected properly,and the management of the perioperative period is much concerned as well as the easy-going effective way of the operation is taken.