老年人急性胆囊炎的腹腔镜手术治疗

目的:探讨老年人急性胆囊炎的临床特点,更好地把握腹腔镜胆囊切除(LC)术的时机和方法。方法:回顾分析32例老年人急性胆囊炎LC的临床资料,比较早期(急性发作48h内)LC及延期(急性发作48h后)LC的治疗结果。结果:早期及延期LC均获成功,患者全部治愈,未发生严重并发症;但延期LC的平均手术时间及术后平均住院日期较长。结论:老年人急性胆囊炎病情进展快,手术难度大、风险高;只要高度重视围手术期的处理,把握手术时机及技巧,早期LC是安全、可行的;除病情危重不能耐受手术者外,多数患者均应尽早施行LC。

Laparoscopic cholecystectomy for aged patients with acute cholecystitis

Objective: To explore the clinical features and surgical management of aged patients with acute cholecystitis, and try to command the opportunity and procedure of laparoscopic cholecystectomy(LC) better. Methods:Clinical data of 32 aged cases with acute cholecystitis undergone LC were analyzed retrospectively, in the meanwhile, the results of early LC(within 48h of the acute attack)and delayed LC(at the acute attack 48h later) were compared. Results: All of the patients were performed by early or delayed LC successfully and recovered with no serious operative complication, but the latter's mean time spent on LC and postoperative hospitalization was longer. Conclusions: Aged acute cholecystitis progresses rapidly and it's operative difficulty and risk is higher; only if pay more attention to perioperative managements and command operative time and technical skill, early LC for the patients is safe and feasible. Therefore, it should be recommended in the great majority of cases except for the desperate patient whose general condition is too poor to operate.