合并心肺血管疾病老年患者腹腔镜胆囊切除术的围手术期处理

目的探讨合并心肺血管疾病的老年患者行腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）的围手术期治疗经验。方法对2000年1月-2008年6月225例老年患者LC的术前准备及术中、术后处理进行回顾性分析。结果222例成功行LC,3例中转开腹手术。无胆管损伤、胆漏等并发症。7例术后出现肺部感染,3例出现泌尿系感染,经抗炎治疗后痊愈;心肌缺血改变3例。结论正确掌握手术适应证,术前充分准备,术中仔细操作,术中、术后周密的监护和处理,LC对老年患者是安全的。

Perioperative Treatment for Elderly Patients with Cardiopulmonary Diseases Undergoing Laparoscopic Cholecystectomy

Objective To report our experience on laparoseopic eholeeysteetomy （LC） for elderly patients with cholecystitis and cardiopulmonary diseases. Methods Totally 225 elderly patients, who had undergone laparoscopic cholecystectomy in our hospital between January 2000 and June 2008, were retrospectively analyzed. Results Among the cases, LC were completed in 222 patients, the other 3 were converted to open surgery. No bile duet injury or biliary leakage occurred. After the operation, 7 cases developed pulmonary infection, and 3 eases showed urinary infection, all of them were cured by antibiotics. Three cases suffered from cardiac ischemia without further damage. Conclusions With strict enrollment criteria, careful preoperative preparation, skillful operation, and intensive intra- and postoperative monitor, the LC is safe for elderly patients as a minimally invasive surgery.