老年人腹腔镜胆囊切除术412例

目的 :总结老年人腹腔镜胆囊切除术 (LC)的经验 ,并探讨预防和减少老年人LC并发症的方法。方法 :在全麻和CO2 气腹状态下 ,老年人 4 12例行LC术 ,中转剖腹手术 5例 ,行胆囊大部分切除 6例 ,5例术中经胆囊管胆道造影。结果 :全组LC手术成功率 98 8% ,中转剖腹手术 5例 ,无严重的手术并发症 ,及死亡病例。结论 :老年人常伴有其他慢性器官疾病 ,手术耐受性较差 ,LC围手术期危险性明显增高 ,应严格选择手术适应证 ,针对不同的伴随疾病采取相应的措施 ,术中应相对放宽中转开腹的指征 ,是预防和减少并发症的关键。

Laparoscopic cholecystectomy in 412 cases old patients

Objective:To summarize the experience of laparoscopic cholecystectomy(LC) and prevent and the complications in old patients.Methods:412 cases old patients received LC in general anaesthesia and CO 2 pneumoperitoneum. 5 cases of them were converted to open surgery and 6 cases received sectional cholecystectomy. 5 cases received intraoperative cholangiography through cystic duct.Results:The success rate of LC was 98.8%. No death or serious complications occurred.Conclusions:Strictly selecting LC indications, treating the accompanying disease properly, broadening the indications of converting to open surgery and skilled operation are key factors to prevent and reduce complications in old patients with LC.