老年胆道疾病患者的外科治疗

目的 探讨60岁以上老年胆道疾病的外科治疗及效果。方法 回顾性总结1998年1月－2000年12月间452例60岁以上老年胆道疾病患者的手术治疗情况。结果 本组有合并症342例，占75.7%，胆囊切除术249例，胆囊切除及胆总管探查145例，胆肠内引流26例，胆总管内置支架3例。术后发生并发症75例，占16.6%，其中急诊手术组为32.6%，择期手术组为7.08%，总病死率为2.65%。结论 60岁以上老年患者合并症多，应尽可能了解全面病情，适时进行手术治疗，采取合适的手术方式，可提高手术成功率，降低并发症率和病死率。

SURGICAL MANAGEMENT OF BILIARY TRACT DISEASE INTHE ELDERLY

Objective To study the method and effect of the surgical management for biliary tract disease in the elderly.Methods Analysis of the clinic data of 452 aged patients over 60 years with biliary tract discases,who admitted to our hospital from January 1998 to December 2000.Results Various underlying diseases were found in 342 cases.Cholecytectomy was performed in 249 cases,cholecystectomy and choledochostomy in 145 cases,internal biliary drainage in 26 cases.The morbidity rate was 16.6%(32.6% in emergency group,7.08% in elective group).The mortality rate was 2.65%.Conclusion The aged patients have more coexite diseases,and more postoperative complications,so choice of selective operation,reducing of emergent operation,extensive perioperative management are essential.