老年人腹腔镜胆囊切除术521例临床分析

目的探讨腹腔镜胆囊切除在治疗老年人胆囊良性疾病中的应用价值。方法回顾性分析５２１例老年患者胆囊切除术的结果。结果５２１例中，单纯慢性结石性胆囊炎４５９例，其中继发胆总管结石２例，急性胆囊炎２４例，胆囊息肉３８例。术中因炎性粘连、疑胆囊癌等改做开腹手术１８例（３．５％），发生严重并发症３例（０．６％），治愈４９９例（９５．８％），死亡１例。结论为老年人施行腹腔镜胆囊切除术，如医生经过充分的训练并了解可能发生的困难，仍是安全可行的手术方法。

An analysis of laparoscopic cholecystectomy in the elderly: a report on 521 cases

Objective To estimate the value of laparoscopic cholecystectomy (LC) in the elderly with benign lesions of the gallbladder. Methods The results of laparoscopic cholecystectomy in 521 elderly patients were analysed retrospectively. Results Among 521 cases, there were simple calculous cholecystitis in 459 cases, 2 cases of them weve gallbladder stone concomitant with secondary common bile duct stone, acute cholecystitis in 24 cases, and polyps in 38 cases. In 18 cases (3 5%), the procedure was converted to an open cholecystectomy becaure of operative difficulty such as imflammatous adhesion or suspected gallbladder cancer. Four hundred ninety nine patients were cured (95 8%). Major complications occurred in 3 cases (0 6%) and one patient died. Conclusions Lapanoscopic cholecystectomy is a safe and feasible operation in the elderly, when it is carried out by a surgeon properly trained and aware of the pototential hazards.