摘要
目的：探讨老年急性胆囊炎患者的手术方式及手术时机的选择。方法：回顾分析46例高龄腹腔镜胆囊切除（laparoscopic cholecystectomy,LC）患者的手术情况及术后恢复情况。结果：44例（95.65%）成功完成LC,2例（4.35%）中转开腹。手术时间30-180 min,平均（48±2）min;术中出血量50-200 ml,平均（92±3）ml;术中困难主要为胆囊三角冰冻样粘连、急性期化脓坏疽。术中患者均放置胆囊窝引流管,除2例少量胆漏延迟拔管外,余者均于48 h内拔管。术后住院6-10 d,平均（7.0±0.3）d。结论：术前把握手术适应证,加强合并症的围手术期处理,术后加强监护,为老年急性胆囊炎患者行LC是安全、可靠的,可作为首选治疗方案。
Objective： To investigate the surgical methods and surgical timing of elderly patients with acute cholecystitis. Methods： The surgery and recovery of 46 elderly patients who underwent laparoscopic cholecystectomy were retrospectively analyzed. Results： Forty-four cases（ 95. 65%） successfully completed laparoscopic surgery and 2 cases（ 4. 35%） were converted to laparotomy.Operative time was 30-180 min with the average of（ 48 ± 2） min. The mean intraoperative blood loss was（ 92 ± 3） ml（ range 50-200 ml）. The main difficulty was the gallbladder triangle frozen adhesions and acute purulent gangrene. The drainage tube was placed at gallbladder fossa in all patients,except for 2 cases of extubation were prolonged because of a small amount of bile leakage,the remaining patients were extubated within 48 h. Postoperative hospital stay was 6-10 d,with the average of（ 7. 0 ± 0. 3） d. Conclusions： If surgeons master operative indications,strengthen perioperative treatment of coexisting diseases and postoperative wardship,laparoscopic cholecystectomy is safe and reliable,can be used as the preferred method of treatment for elderly patients with acute cholecystitis.
出处
《腹腔镜外科杂志》
2014年第9期715-716,共2页
Journal of Laparoscopic Surgery
