162例老年胆道手术时机与预后分析

目的：探讨老年胆道手术时机与预后的关系。方法：2000-2005年共施行162例60岁以上各类胆道手术。其中起痛72h内急症手术47例；急症入院后先予以保守治疗，同时治疗并存疾病后在7～21d早期手术57例；门诊入院择期手术58例。回顾分析上述病例的手术时机与预后的关系。结果：急症手术组平均住院18d，术后死亡2例（病死率4．26％）；早期手术组平均住院24d，术后死亡1例（病死率1．75％）；择期手术组平均住院22d，术后死亡1例（病死率1．72％）。结论：老年人并存内科疾病多，急症胆道手术后病死率较高。急症先予以保守治疗并积极治疗并存疾病，然后进行早期手术，其预后与择期手术组相同。选择合适的手术时机和盎好的围手术期处理是关键。

Analysis of the Proper Time of Biliary Tract Surgery in Elderly Patients

Objective: To analyse the proper time of biliary tract surgery in elderly patients. Methods: Clinical data of 162 cases (aged from 60 to 93) underwent of biliary tract surgery in our hospital from 2000 to 2005 were analyzed restropectively. Among them,47 cases were operated within 3 days (Group A),57 cases were operated during 7 to 21 days (Group B). The rest 58 cases from out-patient department were underwent elective operation (Group C). Results: In Group A, the average duration of hospitalization was 18 days, 2 patients died . In Group B, the average duration of hospitalization was 24 days, 1 case died . while in Group C, the average duration of hospitalization was 22 days, 1 case died. Conclusion: Proper time and pre-operative management are very important to the elderly patients in biliary tract surgery.