老年人腹腔镜胆囊切除术118例报告

目的探讨老年人腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）的特点。方法回顾性分析2000年1月～2005年1月我院收治的118例老年病人LC的临床资料。结果116例顺利施行LC，中转开腹手术2例，其中1例为胆囊管开口于胆总管下端，另1例胆总管损伤。LC手术时间30～120min，平均50min。术后均恢复顺利。术后住院3～7d，平均4．5d。1例胆总管损伤术后随访2年6个月，有短暂的腹痛和发热，应用抗生素2—5d后症状消失，无胆道狭窄和胆道结石。余117例术后随访6～12个月，平均10．5月，无腹痛、发热、黄疸等并发症。结论老年人可耐受LC，且安全可靠，充分的围手术期处理、仔细的手术操作是成功的关键。

Laparoscopic cholecystectomy in elderly patients: A report of 118 cases

Objective To investigate the characteristics of laparoscopic cholecystectomy(LC) in the elderly. Methods A retrospective analysis was made on clinical data of 118 elderly patients treated with LC in this hospital between January 2000 and January 2005. Results The LC was successfully completed in 116 patients,while conversions to open surgery were required in 2 patients due to low level of insertion of the cystic duct(1 patient) and common bile duct injury(1 patient).The operation time was(30~120 min)(mean,50 min).The postoperative recovery was uneventful in all the patients.The length of hospital stay after operation was 3~7 d(mean,4.5 d).The patient with common bile duct injury was followed for 2 years and 6 months.Transient onsets of abdominal pain and fever were noted and cured with antibiotics for 2~5 days.No biliary tract stenosis or bile duct calculus was seen.Follow-up observations in the remaining 117 patients for 6~12 months(mean,10.5 months) revealed no abdominal pain,fever,or jaundice. Conclusions Laparoscopic cholecystectomy is acceptable and safe for elderly patients.Proper peri-operative management and careful surgical performance are essential to the success of surgery.