老年人急性胆囊炎的微创治疗体会(附48例报告)  

The treatment experience of minimally invasive in elderly with acute cholecystitis( with 48 cases report)

作　　者：吴国庆[1] 王国范[1] 

机构地区：[1]北京市怀柔区中医医院外科,北京101400

出　　处：《临床和实验医学杂志》2015年第8期642-644,共3页Journal of Clinical and Experimental Medicine

基　　金：首都卫生发展科研专项基金资助项目(编号:201301921)

摘　　要：目的总结老年人急性胆囊炎的微创治疗经验。方法回顾性分析2009~2014年采用微创手段治疗老年人急性胆囊炎患者48例的临床资料并进行总结。结果 48例急性胆囊炎老年患者中,急诊行腹腔镜胆囊切除术（LC术）38例,中转开腹1例,无严重并发症;行超声引导下胆囊穿刺引流术（PTBD术）10例,其中6例3~6个月后择期行LC术,无中转开腹及严重并发症;3例PTBD术后3~6个月拔管观察;1例选择长期带管生存;全组无死亡病例。结论老年急性胆囊炎患者在排除禁忌证的情况下,应争取尽早明确诊断并行微创手术治疗;对于存在治疗禁忌证或错过最佳治疗时机的患者,PTBD术是有效的微创干预手段;合理选择外科干预时机和干预手段、重视围手术期处理可减少和避免并发症的发生。Objective The aim of this study is to sum up the experiences of minimally invasive treatment of elderly acute cholecystitis.Methods The clinical data of 48 elderly cases of our hospital with acute cholecystitis treated by minimally invasive method from 2009 to 2014 were retrospectively analyzed. Results In all 48 cases,38 cases received the emergency LC operation,1 case received laparotomy without serious complications,10 cases received ultrasound guided gallbladder puncture drainage（ PTBD）,6 cases received elective LC 3 ~ 6 months later without severe complications,3 cases were followed up 3 ~ 6 months after PTBD extubation,1 case were treated with tube with long- term survival. No death was reported in whole cases. Conclusion Under the condition of elderly acute cholecystitis patients without contraindications,these patients should be diagnosed at the early phase and received minimally invasive surgery. In the treatment of patients with contraindications or missing the best treatment time,PTBD is effective minimally invasive interventions. During the treatment,selecting reasonable surgical intervention,methods,attaching great importance to the perioperative management can reduce and avoid the occurrence of complications.

关 键 词：老年人 急性胆囊炎 微创手术 

分 类 号：R657.4[医药卫生—外科学]