老年胆石症186例手术治疗探讨

目的:探讨老年胆石症的临床特点、围手术期处理、手术时机及手术方式选择.方法:对1999年3月～2005年10月行手术治疗的186例老年胆石症临床资料进行回顾性分析.结果:手术治疗老年胆石症186例,治愈160例(86.0%),好转19例(10.2%),死亡7例(3.8%);胆囊切除134例,胆囊切除加胆总管探查取石34例,胆总管探查取石8例,胆肠吻合7例,胆囊造瘘3例.结论:老年胆石症应重视围手术期处理,正确选择手术时机和手术方式,除有严重的并存病外,应积极手术治疗.

Surgical Management of Cholelithiasis in the Elderly: Report of 186 Cases

Objective:To explore the clinical character of cholelithiasis in the elderly,the time for surgical operation and choices of modus operandi.Methods: A retrospective analysis was performed on 186 cases of cholelithiasis in the elderly who underwent surgical management between March,1999 and October,2005.Results: Of these 186 elderly patients with cholelithiasis,160 were cured(86.0%);19 got improved(10.2%);7 died(3.8%);134 underwent cholecystectomy;34 received cholecystectomy plus exploration of the common bile duct and calculus removed;8 underwent exploration of the common bile duct and calculus removed;3 were given gallbladder fistulation.Conclusion:Attention should be attached to peri-operational management of cholelithiasis in elderly.The time for surgical management and modus operandi should be properly chosen.Surgical treatment should be actively taken unless serious complications were encountered.