腹腔镜在老年人胆囊疾病手术中的应用及主要合并症的处理

目的:探讨腹腔镜在老年人胆囊疾病手术中的应用及主要合并症的处理。方法:回顾分析528例老年人胆囊疾病行腹腔镜胆囊切除术(LC)的临床资料。结果:术后胆漏2例,出血1例,1例术后并发大面积脑梗塞,经治疗无效2周后死亡。1例胆囊与胃形成内瘘,合并糖尿病,中转开腹手术,术后切口感染,并发肺炎,呼吸功能衰竭术后3周死亡。结论:老年人胆囊疾病多合并糖尿病、高血压、冠心病、肺部疾病、肝与肾疾病,增加了手术风险。只有对合并症进行治疗和纠正,才能安全度过手术关。

The application of laparoscopy in gallbladder diseases of the aged and the disposal of major complications

Objective:To explore the application of laparoscopy in gallbladder diseases of the aged and the handling of major related complications.Methods:The clinical data of 528 old patients with gallbladder diseases underwent laparoscopic cholecystectomy(LC)was retrospectively analyzed.Results:Postoperative bile leakage and bleeding were found in 2 and 1 cases respectively.1 patient complicated large-area cerebral infarction died two weeks later.Complicated with diabetes,one case was converted to laparotomy due to internal fistula between gallbladder and stomach.The patient suffered from incision infection and pneumonia,and eventually died of respiratory failure 3 weeks after the operation.Conclusions:The operation risk increases in the old people with gallbladder diseases,because most of them complicate with diabetes,hypertension,coronary artery disease,pulmonary disease,hepatic disease or renal disease.In these cases,the treatment and handling of related complications are very important for the success of the operation.