老年人行腹腔镜胆囊切除术的特点

目的:探讨老年人腹腔镜胆囊切除术的特点。方法:分析266例老年人(≥65岁)行腹腔镜胆囊切除术(LC)的手术时间、中转剖腹手术例数、住院天数、手术并发症、围手术期肺功能和血气分析变化,分别与中青年患者LC及老年患者剖腹胆囊切除术(OC)比较。结果:老年人LC平均手术时间为39min,手术中转率为5.6％,手术并发症占5.3％,均高于中青年LC患者,但明显低于OC的老年患者,且比较轻。但老年患者LC后的肺功能减退(10.2％)和高碳酸血症(20.3％)明显多于OC,多数可在术后短时间内恢复。结论:与OC比较,老年人LC仍是一种损伤小、安全可靠和恢复快的理想手术方法,但要针对老年患者的特点以及LC可能引起的肺功能下降和高碳酸血症,做好术前处理、术中及术后监测和并发症的预防。

The characteristics of laparoscopic cholecystectomy in the elder

Objective:To explore the characteristics of laparoscopic cholocystectomy(LC) in the elder. Method: The results of (LC)in266 elderi patients (≥65yr) with benign lesions of the gallbladder were analysed retrospectively. Result: In comparing with LC of young to middle aged patients and elder with an open cholecystectomy (OC), the mean duration of the LC was 39 min, the rate of conversion to OC was 5.6%, and the rate of complications was 5.2%. These numbers in the elder with LC were higher than in young to middle aged patients and much less than elder with OC. However, the impairment of pulmonary function and hypercarbia were found in 10.2% and 20.3% of elder with LC respectively,which were much more than those in the OC group. Most of the patients recovered in short period of time. Conclusion: Compared with OC, LC is an effective, safe and feasible operation in elder. Some measures should be taken around the operations to protect impairment of pulmonary function, hypercarbia and the complications due to LC.