老年人腹腔镜胆囊切除术后近期再手术临床分析:附35例

目的 探讨老年人腹腔镜胆囊切除术(LC)后近期再手术的原因及防范措施.方法 回顾性分析1993年1月至2007年9月老年病人LC术后近期再手术的35例临床资料.结果 35例病人经再手术治疗后34例获痊愈,其中再手术后发生并发症11例.分别为切口感染2例、腹腔残余脓肿1例、肺部感染3例、应激性溃疡2例、胆管炎1例、下肢深静脉血栓形成2例,均予对症处理,1例于再次手术后第3天死于应激性溃疡.结论 重视病史询问、完善术前检查,严格选择适应证、规范手术操作、适时中转开腹以及针对老年病人的一些特殊措施是减少老年病人LC术后近期再手术的关键.

Reoperation shortly after laparoscopic cholecystectomy in aged patients: a clinical analysis of 35 cases

Objective To explore the reasons and preventive measures for reoperation shortly after laparoscopic cholecystectomy (LC) in aged patients. Methods The clinical data of 35 aged pa-tients receiving reoperation shortly after LC were retrospectively analyzed. Results Of the 35 pa-tients, 34 were cured after the reoperation. Eleven of which had postoperative complications including 2 with infected incisional wound, 1 with abdominal residual abscess, 3 with pulmonary infection, 2 with stress ulcer, 1 with cholangitis, 2 with thrombogenesis in the deep veins of lower limb. All the 11 cases were expectantly treated. The other patient died from stress ulcer on the third day. Conclu-sion The keys to reduce rate of reoperation shortly after LC in aged patients are paying attention to inquiring case history, perfecting preoperative examination, selecting indications strictly, standardi-zing operative procedures, using laparotomy timely and adopting special measures.