老年人腹腔镜胆囊切除的临床评价与风险防范

目的 :评价老年人腹腔镜胆囊切除术 (LC)的安全性及可行性 ,探讨防范风险的应对措施。方法 :比较、分析 6 0岁以上老年人LC组 (n =74 )、开腹胆囊切除 (OC)组 (n =36 )及中青年LC组 (n =2 82 )的临床资料。结果 :老年人LC及OC组并存病显著高于中青年LC组 (P <0 0 0 1 )。LC组患者术后恢复良好 ,未发生严重并发症 ;平均手术时间 ,平均术后住院天数及中转开腹率两组差异均无显著性 (P >0 0 5 ) ;而OC组平均手术用时、平均术后住院天数均显著延长 (P <0 0 0 1 ) ,且并发症多 (P <0 0 5 )。结论 :只要高度重视围手术期的处理 ,正确评估麻醉与手术的风险 ,把握手术时机及技巧 ,对老年患者施行LC不仅安全可行 ,而且更能凸现微创的优越性

Clinical evaluation and measures to keep away the risk on laparoscopic cholecystectomy for elderly patients

Objective:To evaluate the safety and feasibility of laparoscopic cholecystectomy(LC)in elderly patients,and explore measures how to keep away it′s risk.Methods:The clinical data of elderly patients treated by LC(n=74) and open cholecystectomy(OC)(n=36),whose age were over 60 was analyzed retrospectively and compared with that of the other adult patients(n=282)undergone LC at the same stage.Results:The rate of combined other disease was extremely significant higher in the two elderly groups(P<0.001).Both of the two groups of LC were recovered smoothly with no serious complications;there were no significant different about the mean time spent on LC and postoperative hospitalization as well as the rate of converting to laparotomy between the two LC groups(P>0.05).But it was found the two indexes were extremely significant longer(P<0.001),and postoperative complications increased too(P<0.05).Conclusions:Only if pay more attention to perioperative managements,estimate the anaesthesia and operation correctly and command operative time and technical skill.Not only LC is safe for elderly patients,but also its great advantage of minimally invasive surgery will emerge further.